Interoception is perhaps the lesser known eighth sense. Just like taste, sight, smell, touch, hearing, proprioception and vestibular; we use interoception to help us make sense of the world and what we experience each day. More specifically, interoception helps us feel or sense what is happening inside of our body like hunger, thirst, feeling hot or cold, if we have a full bladder and fatigue. It can also help us interpret emotions. Think for a moment about how you know when you are anxious. Perhaps you feel fluttery in your stomach, your chest might feel tight, your heart might beat faster, your palms may become sweaty. These are signals that help you identify exactly how you feel and that feeling is ‘anxiety’.
But what if your child has trouble interpreting the messages their body is presenting? Many Autistic children and adolescents experience differences with interoception. This makes it harder for them to make sense of the information their body is transmitting and to self-regulate. In this blog, we will look at how the interoceptive system works and how Occupational Therapists help Autistic children and young adults build body awareness and interoception skills.
Interoception and Body Awareness
As mentioned above, interoception is our internal body sense. All our muscles and joints have receptors which tell the brain where our body parts are. Interoception works in a similar way, however, the receptors are in our organs and our skin. These receptors send messages about the body to the brain. The brain helps make sense of these messages and allows us to recognise many important sensations including hunger, fullness, pain, nausea, need for the bathroom, body temperature, and physical exhaustion. In this same way, the signals from out interoceptive system are used as clues to help us recognise and feel our emotions.
When it comes to our emotions, our bodies give us signals to let us know how we are feeling. For example, if you are about to talk in front of a large group of people, your body may feel a certain way. Your heart might race, your muscles might tense, your breathing may become shallow and you may feel fluttering in your stomach. These sensations are letting you know that you feel nervous. Some people’s bodies send out really small signals which makes it difficult for them to understand what their body is trying to tell them. These signals can also be too big, causing emotions to feel bigger than others might expect. Other people may have appropriate size signals, however struggle to identify what emotion their body is causing them to feel.
If our interoceptive system is working correctly, we can gain a clear understanding of what our body is trying to tell us and can take action when it comes to restoring balance and feeling more comfortable. For example, if you feel thirsty, you have a drink. If you feel cold, you put on a jumper. But what if these feelings aren’t clear and we do not understand what our body is trying to tell us? This leads me to the challenges Autistic children may experience when it comes to their interoceptive system.
Interoception and Autism
As with other sensory systems, interoception can be impacted in Autistic individuals. They may experience what we call ‘differences’ with interoception:
- For some people, body signals can feel very intense. For example, some people may feel so many things going on inside their body at once, that it makes it hard for them to make sense of it all and respond appropriately.
- For others, body signals can feel dull or muted. This can make it difficult for them to understand their feelings until they have reached ‘melting point’. It can also make it more difficult to take appropriate action. For example, if an individual has difficulties recognising that they need to use the bathroom, they may choose not to drink to avoid having an accident.
Either way, unclear body signals make it hard to identify exactly how you feel, and this can affect many aspects of life, including:
- Self-regulation / Managing Emotions
- Toileting
- Sleeping
- Experiencing Pain
- Staying Focused
- Healthy Eating
- Dealing with Stress
- Identifying Symptoms when Sick
Think about it for a moment. If you are experiencing intense feelings or sensations within your body, but you do not understand what they mean, you may struggle to communicate what is going on and feel frustrated, you may have an accident or feel out of control. These reactions can contribute to negative behaviours and could lead to ongoing social challenges.
Therefore, interoception is quite a ‘hot topic’ among Occupational Therapists. We see many benefits in helping Autistic children gain awareness of their body signals and learn to take / make the appropriate action.
How OT’s Help Children Build Body Awareness and Understand what their Interoceptive System is Telling Them
Like many professionals working with Autistic children, Occupational Therapists are keen to help them improve their daily lives through increased independence and awareness. When it comes to interoception and body awareness, we take a hands-on, visual and individual approach to help our clients understand their body, the feelings they have and what they can do when they experience certain sensations.
One of our favourite ways to help children connect the dots between their body’s signals, patterns in those signals, and identifying each with a particular emotion is creating a body check chart.
A body check chart involves grabbing a large piece of paper, having a child lay on that piece of paper and tracing around the outside of their entire body. When this is complete, you have an outline of the child’s body that can be used to help build interoceptive awareness, and some of our favourite activities include:
Building Body Awareness
We can use the body check chart to do various activities designed to help children understand their chart and how it relates to their body, including:
- Pointing to different body parts on the chart and having the child wriggle that body part on their actual body
- Playing a game of Simon Says that involves actions related to interoception i.e. clenching fists, heavy breathing, touching your heart. The child can then point to the body parts on the chart that they used for each action
- Drawing and labelling all their body parts on the chart
- Pointing to a body part on the chart and asking the child how it feels now.
Self-Awareness and Emotional Regulation
These activities help children start building a deeper understanding of the sensations in their bodies and the emotions they are feeling, and can include:
- Drawing feelings on the chart using different coloured pens / textas for each feeling
- Identifying what signals they can feel after a favourable activity. For example, if they have just had a play in the sensory gym and are feeling happy, we might ask them to point out on their chart what body sensations are letting them know they are feeling happy. If that is a bit tricky, we might even use the chart before and after the activity to help the child identify the difference in sensation the activity caused.
- Identifying what body sensations are letting them know that they are feeling big emotions such as frustration or anger. Identifying these emotions is tricky as often children feeling such big emotions are not in the best state to learn. Using the body check chart for these emotions is only used once a child can easily identify body sensations while in a calm and well regulated state.
In addition to the above, we may also look at activities to help with sensory processing, including the development of a sensory activity schedule that incorporates sensory rich activities including a combination of altering (increase arousal or body awareness), organising (‘just right’ activities to help maintain focus and regulate) and calming (decrease arousal and relaxing) activities.
Tuning in to our bodies and understanding everything it has to say is not always easy. This is especially the case for Autistic children and those with atypical sensory processing. Our interoceptive system provides endless information that we need to navigate and understand every minute of every day. If these messages or sensations are experienced differently, it is harder to understand what we need to do to regulate.
To improve interoceptive awareness, we need to help children think about their bodies. Through interactive activities like the body check chart and many more, children can build introceptive awareness and begin to understand the messages their body sends them and what those messages mean. Over time, they can use this information to respond to the sensations independently and appropriately and improve self-regulation.
If your child or someone you know is struggling with their interoceptive sense and would benefit from an Occupational Therapy assessment and program, please contact our team today.
