What is interoception?

We all know the five senses: sight, hearing, smell, taste, and touch. They help us connect with the world around us. But have you heard about interoception? It’s the sense that helps us understand how we feel inside at any moment.

Interoception is important for everyone, especially for people with autism who might experience sensory things differently. These differences can make it tricky for them to recognise and respond to their internal feelings, which can affect their overall well-being.

Interoception plays a big role in our lives, helping with self-regulation, mental health, and social connections.

How does Interoception Work?

Interoception is always busy, monitoring your entire body. It keeps track of your heart, lungs, stomach, bladder, muscles, skin, and even your eyeballs, gathering information about how they feel. For example, interoception helps your brain understand how your stomach feels—whether it’s empty, full, gassy, nauseous, tingly, or something else.

Your brain uses this information to understand your current emotions. Are you hungry, nervous, tired, sick, or excited? Interoception detects internal signals like hunger, thirst, temperature changes, and the need to use the toilet. It helps maintain your internal balance and overall well-being by prompting you to take action based on what you feel. For instance, if you’re low on water, interoception will make your mouth feel dry, prompting you to drink.

Another example is when you notice a tight feeling in your chest, a racing heart, and tense muscles. These sensations might tell you that you are anxious and urge you to seek comfort from a loved one.

Why is Interoception Important?

Interoception is the key to independent self-regulation. In other words, understanding your body’s signals is the key to managing your own emotions and behaviours independently.

Being aware of your body signals not only helps you understand how you feel (like content, happy, or anxious) but also gives you information about your current situation (like what you are doing or where you are).

If you feel dysregulated, these signals alert you that something is off and motivate you to take action to restore your balance and comfort. In other words, noticing how your body feels drives you to self-regulate.

Being aware of your body signals also helps you recognise if someone has behaved inappropriately towards you. If this happens, you should discuss it with a trusted adult (see section on protection against abuse)

Interoception and Autism

For people with autism, interoception can be too sensitive or not sensitive enough. This makes it hard to recognise and respond to bodily sensations, which can make it difficult to communicate feelings and get help. It’s more common to be not sensitive enough, meaning reduced body signals. When overly sensitive, they feel everything with greater intensity.

Imagine if your inner sense of your body’s feelings was unclear or confusing. What if you couldn’t feel what was happening inside your body? What if you noticed feelings inside but had no idea what they meant? Or what if your internal sensations were so intense that you felt unsafe every day?

This is the reality for many people. Individuals with conditions such as autism, ADHD, depression, anxiety, toilet training difficulties, sensory processing disorder, and behavioural challenges often experience difficulties with interoception.

Strategies to Improve Interoceptive Awareness

Occupational therapists can help improve interoception and body awareness, by using hands-on, visual, and personalised approaches to help children with autism understand their bodies, recognise their feelings, and learn what to do when they experience certain sensations.

These are five simple things that can help a child with autism improve interoception.

1. Feel your Heartbeat Challenge:

• Play a game with your child to get their heart beating: jumping jacks, jump rope, etc.
• Pause to “catch the heartbeat.”
• Ask the child to describe the sensation of their heartbeat.
• Prompt with questions like:
  • What colour does it feel like?
  • Describe the sensation.
• Encourage the use of sensation-based words, e.g., “buzzy,” “thump-thump,” “whizzy” (words can be made-up).

2. Create a Body Check Chart

• Use a large piece of paper and have the child lay on it.
• Trace around the outside of the child’s entire body.
• You can now use this outline as a body check chart to do a number of different activities:
  • Point to body parts on the chart and have the child move those parts.
  • Play Simon Says with actions related to interoception (e.g., clenching fists, heavy breathing). The child points to the corresponding body parts on the chart.
  • Draw and label all body parts on the chart.
  • Point to a body part on the chart and ask the child how it feels.

3. Sensory Champions Exercise

• Choose a body part, such as their hands.
• Use different sensations like a hot pack and a cold pack, applying each for about 10 seconds.
• Think about how each sensation feels and describe it out loud or in writing.
• Reflect on the emotional responses, such as feeling warm and fuzzy with the hot pack or more alert with the cold pack.

4. Body Scan Meditation

• Get your child to sit or lie down comfortably in a quiet area.
• Guide them to focus on the top of their head and imagine a scanning beam moving down their body.
• Have them describe any sensations (squishy, tense, tight, soft) that they feel as the beam moves down from their to their toes.
• Spend a few moments focusing on the sensations in each area.

5. Develop a Language for Pain or Discomfort

• Many children with autism and ADHD report “stomach pain.”
• Encourage them to describe their pain: throbbing, sharp, like rocks, etc.
• Help them identify different types of pain.
• Guide them to recognise whether the pain is due to hunger, worry, or a stomach ache.
• It will take time to learn how to distinguish between different body signals.
• Starting with small observations will help them to gradually build up a foundation to later be able to distinguish between different body signals.

Consistent Effort Improves Self-Regulation

Practising interoception is like looking at yourself in the mirror, but from the inside. With consistent effort, children with autism become more aware of their internal body sensations. This helps them understand and respond to their body’s needs, improving overall well-being and enhancing their ability to communicate their needs.