The interoceptive system: Responsible for autonomic motor control. That is our unconscious movements such as blinking, breathing, flinching, etc. This system is responsible for the feelings and sensations inside our bodies. This system is one of the senses, which in children with autism or sensory processing difference, can function atypically. The interoceptive system, and interoceptive awareness is how we recognize pain, itch, hunger, thirst, muscular sensations and more.
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 can 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.
How Does Interoceptive Awareness Affect Emotional Regulation?
Does your child struggle with emotional regulation, or identifying emotions? Are the able to tell you what they are feeling? Every emotion that we have feels a certain way inside our bodies.
When you are angry, your heartrate 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 can be more difficult form them to recognize their emotions because they aren’t making those connections between what happens in their bodies and what they feel, or they aren’t feeling those sensations in a typical way.
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.
A kiddo with ASD may not recognize these cues from the interoceptive system. There are children who seem to have an extremely high pain tolerance, or need to be reminded to eat, for example. Those needs are still there, they just aren’t being processed and recognized. As well, if your child struggles with communication they may not be able to express these needs, or understand them.
Because of this – you may need to prompt your child. If your child struggles with self-regulation and you see they are becomming dysregulated and behavior is 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 shows that in order for the needs at the top to be met, we must first have the needs at the bottom of the pyramid met. So in order for our kids to reach their full potential, we need their other needs to be met first. This is important 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.
What Else Is Effected By Interoception?
In addition to emotions and self-regulation, the interoceptive system also affects:
- Self awareness
- Problem solving
- Perspective Taking
- Social Understanding
- Flexibility of Thought
These are all skills individuals with ASD are more likely to struggle with. Low interoceptive awareness may also explain why potty training is a common challenge. Or why your child may be completely fine one minute and the next minute they are screaming they are hungry and need to eat “right now!” Because they weren’t aware of those sensations until they became urgent.
How Can You Improve Interoceptive Awareness?
Occupational Therapists can help with improving interoception by providing specific sensory input to increase your child’s self awareness.
Body check chart
This activity is from FamilySpeech.com, written by Kristen Connel, OTR/L – Read the full article here.
Begin this process with positive experiences like after running around outside, after a warm shower, after a meal, etc.
Draw an outline of the person. Label specific parts-head, eyes, ears, mouth, voice, chest, heart, hands, stomach, feet, skin, muscles, etc.
Have the child label one body part and how it feels at that moment (i.e. eyes-sleepy, awake, watery, itchy, dry, etc). Continue to add body parts and corresponding sensations, depending on the level of the child.
After noticing the sensations of various body parts, give each sensation meaning. For example:
- when your eyes are watery/itchy, it means you are tired
- when your heart is beating fast, you may feel nervous or angry about something
- when your stomach makes a grumbly noise, it means you are hungry
As the child continue 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)
Trace their body on a large piece of paper. Point to a body part on the drawing and have them wiggle it on their own body to build body awareness. You could also play a game of Simon Says to build awareness: touch your heart, clench your fists, breath really fast.
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 to their sense of self and begin to understand their body’s signals.
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. As well as practical strategies that can be used to improve interoceptive awareness, and self-regulation.
As well, this book Listening to My Body is a book directed towards kids, explaining body sensations to them and providing activities to try.