7 Way to Improve Interoceptive Awareness

The Interoceptive System – 7 Ways to Improve Interoceptive Awareness

The interoceptive system is the least known and least understood sensory system. It’s the sense of our bodies’ internal state. It’s how we feel and understand what’s happening inside ourselves.

The interoceptive system also controls autonomic motor movements. That is our unconscious movements such as blinking, breathing, flinching, etc. 


This post is part of a 10 part series on the sensory systems. Each part will contain a table of contents to help you easily navigate through the entire series.

Table of Contents:

  1. Introduction – The Sensory Spectrum
  2. The Tactile System
  3. The Auditory System
  4. The Visual System
  5. Proprioception
  6. Vestibular System
  7. Interoception
  8. The Olfactory System
  9. The Oral-Motor System
  10. Bilateral Coordination

The interoceptive system and interoceptive awareness are how we recognize pain, itch, hunger, thirst, muscular sensations, being tickled, needing the washroom, our emotions and more.

Processing differences related to the interoceptive system can cause significant challenges for children. Not only does this impact their understanding of what’s happening inside their bodies – but it also severely impacts emotions and how to identify emotions. 

How Does the Interoceptive System Work?

Although the interoceptive system is not completely understood, what we know is — sensory receptors (about 90% of these are free nerve endings) throughout the body located in the muscles, organs, bones, joints, etc send neural signals to the insula located deep in the brain. The insula processes and decodes these messages and then alerts us to any changes in our body’s internal state.

This also allows us to feel emotions – because our various emotional states cause different sensations inside the body which are decoded and allow us to understand how we’re feeling.

Different emotions produce different feelings inside our bodies – this is how we distinguish how we feel.

The Interoceptive System Affects:
  • Self-awareness
  • Problem-solving
  • Perspective taking
  • Social Understanding
  • Flexibility of thought
  • Intuition
  • Emotional recognition and regulation

Interoceptive Awareness

If I asked you right now, how you feel inside your body, could you tell me? Is your heart beating fast or slow? Are you tense and sore? Do you need to use the washroom? You’re able to answer these questions because you have interoceptive awareness.

Children with ASD, SPD, or ADHD may not recognize these sensations in a typical way. Current research suggests that individuals with autism have much lower levels of interoceptive awareness compared to neurotypical peers.

Current research suggests that for most children with autism if their interoceptive system is impacted it is hyposensitive. However, hypersensitivity is possible, too. Your child may even struggle with both. 

Some children with autism have a heightened awareness of internal cues that most of us filter out (like our heart rate and breathing), which can interfere with their ability to pay attention to important sensory input.

How Does Interoceptive Awareness Affect Emotional Regulation?

Does your child struggle with emotional regulation, or identifying emotions? Are they able to tell you what they are feeling? Every emotion that we feel has a corresponding sensation in the body.

When you are angry, your heart rate may increase and your face might feel warm.

If you’re nervous you get butterflies in your stomach.

When you’re sad your heart may literally hurt, you may lose your appetite.

However it is that your body responds – you are able to recognize your emotions, intuitively.

If your kiddo lacks interoceptive awareness it will be more difficult for them to recognize their emotions because they can’t make the connection between their body sensations and what they’re feeling emotionally.

Interoceptive Awareness & Meeting Basic Needs

How does interoceptive awareness affect the ability to meet our basic needs?

It’s simple, for us. If you are hungry – you eat. When you feel full – you stop eating. When you are thirsty – you get a drink. Tired – go to sleep.  Cold – put on a sweater. Warm – take off the sweater.

Our interoceptive awareness tells us that something is off inside our bodies and we seek a solution. However, someone with autism may not recognize these cues from the interoceptive system. For example, some children appear to have an extremely high pain tolerance, or they need to be reminded to eat.

For this reason, if your child struggles with self-regulation and you see they are becoming dysregulated and inappropriate behaviors are escalating, you should first consider internal problems. Offer them a snack or drink, or ask if they need to try to use the washroom, etc. Your prompt can be visual or verbal depending on their individual abilities.

Maslow’s Hierarchy of Needs

Maslow’s Hierarchy of needs shows that in order for the needs at the top to be met, we must first fulfill the needs at the bottom. Therefore, in order for our kids to reach their full potential, we need their other, more basic needs to be met first.

This is important and applicable throughout life – but for children, in school especially. If your child is in school, and they are hungry, tired, sick, in pain, etc. and their interoceptive awareness is not integrated well enough for them to communicate those needs, they won’t be learning at their true potential.

This is why when behavior is escalating or there are cues your kiddo is going to have a meltdown we need to consider all these factors including internal needs and the external environment in order to prevent meltdowns. You can read about proactively preventing meltdowns here.

Interoceptive Awareness , How Interoception effects kids with autism - Marlows Heirarchey of Needs
Haslow’s Hierarchy of Needs

What Else Is Affected By Interoception?

In addition to emotions and self-regulation, the interoceptive system also in plays a role:

  • Self-awareness
  • Problem-solving
  • Perspective Taking
  • Social Understanding
  • Flexibility of Thought
  • Intuition

Low interoceptive awareness may also explain why potty training is such a common challenge. It’s the reason why your child may be completely fine one minute and then they are screaming they are hungry and need to eat “right now!”  the next minute.

It’s likely they aren’t aware of those bodily sensations until they become urgent.

Signs Your Child Is Struggling With The Interoceptive System

Modulation Issues

Occurs when the brain over- or under-responds to sensory input. With Interoception, over or under responsiveness can be caused by either:

  1. The strength of the neural signal – stronger, or weaker than typical
  2. The way the brain perceives the signal

Over-Responsive (Hypersensitive)

  • Intense reactions to hunger or needing to use the bathroom. They may even describe hunger as being painful.
  • Struggles with focus and attention (because they’re preoccupied with internal stimuli)
  • Extreme anxiety over minor dilemmas
  • Frequently feels nauseous 
  • Uses the washroom frequently, unexplained by another medical condition

Under-Responsive (Hyposensitive)

  • Extremely high pain tolerance
  • Late toilet training
  • Doesn’t feel when they need the washroom – accidents and/or constipation
  • Doesn’t feel hungry
  • Can’t tell when they are full after eating 
  • May not react to being hot or cold 

How Can You Improve Interoceptive Awareness?

How The Interoceptive System Works & 7 Activities for Kids That Build Interoceptive Awareness // #Autism #ADHDKids #SelfAwareness #Mindfulness #SPD #SensoryActivities #SensoryDiet #BodyAwareness #ToddlerDevelopment #EmotionalRegulation

Interoceptive awareness is measured using the Multidimensional Assessment of Interoceptive Awareness (MAIA). There are also mental exercises used for targeting and improving IA. Studies show that body scans and breathing exercises common in mindfulness practices improve interoceptive awareness when done daily.

Research on strategies to help kids with over-responsiveness to interoceptive input is very scarce. However, mindfulness activities may help children develop a better understanding of their bodily sensations and what they mean. This may help take some of the “urgency” out of these intense sensations. 

An occupational therapist can help improve interoceptive awareness by providing specific sensory input to increase your child’s self-awareness.

Body Check

Older children:

Begin this process with positive experiences like after running around outside, after a warm shower, after a meal, etc.

  1. Lay out a large roll of paper on the floor. Get your child to lay on it , then draw an outline of them.
  2.  Label specific parts-head, eyes, ears, mouth, voice, chest, heart, hands, stomach, feet, skin, muscles, etc.
  3. Have the child label one body part and how it feels at that moment (i.e. eyes-sleepy, awake, watery, itchy, dry, etc).  
  4. Continue adding body parts and corresponding sensations, depending on your child’s abilities
  5. After noticing the sensations of various body parts, give each sensation meaning. For example:
    1. when your eyes are watery/itchy, it means you are tired
    2. If your heart is beating fast, you may feel nervous or angry about something
    3. when your stomach makes a grumbly noise, it means you are hungr
  6. As the child continues to progress, have them match different body states or emotions to their specific body sensations. (i.e. Nervous: hands sweaty, heart racing, legs moving, stomach fluttery)

Younger children:

  1. Trace their body on a large piece of paper.  Then point to a body part on the drawing and have them wiggle it on their own body to build body awareness.
  2. Play a game of Simon Says to build awareness. Use actions like touch your heart, clench your fists, breath really fast.
  3. During a body state/emotion-label the body sensations you see, in a non-judgmental way (your hands are wiggling, you are breathing fast), and write it on the drawn body.

This will help bring about awareness of their sense of self and begin to understand their body’s signals.

Mapping Feelings

You can also use this printable activity to build body awareness. Print out several copies and get your child to color it in at different times to show what they are feeling.

For example if they are angry, they may color their hands and head red, and draw their heart to show it’s beating really fast. If they are scared they may color lines in their belly to show its worried and their knees to show they feel weak.

This worksheet can help children notice patterns between their body sensations and their emotions over time, which will help them better identify their feelings.

Essential Oils

Some research suggests copaiba oil improves interoceptive awareness. For example, adding it to a diffuser may help with emotional well-being. Alternatively, massaging a single drop into the lower abdomen before bed may reduce bedwetting (another common problem with less interoceptive awareness). You can find more information about essential oils here.

Other Strategies

  • Teach children to apply gentle pressure to their lower abdomen to help them feel if their bladder is full.
  • Verbally label what your child is feeling for them. For example, “I see you are crying, you must be feeling sad.”
  • Consider internal issues as a cause of behavior issues – Ask yourself how long has it been since your child ate, had a drink, are they dressed appropriately for the weather, etc.

Additional Reading:

Interoception: The Eighth Sensory System  By Kelly Mahler is available on Amazon.  I have not personally read this book yet – but it is on my short list of books to read. The author boasts this book provides a detailed description of the connection between interoception and the common experiences of individuals with autism. The book also includes practical strategies for improving interoceptive awareness and self-regulation.


Interoceptive Awareness - 7 Ways to Improve Interoception - #Autism #ADHD #SPD #SensoryPlay #SensorySystems #OT