Interoception: Is This the Missing Link to Understanding Your Child?

by Integrate Family | Feb 1, 2021 | Autism & Sensory Education, General for Special Needs Children & Parenting

Ever wonder what feeling hungry and being rigid and inflexible have in common?  How about meltdowns and having empathy for other people?  Well, today we are going to talk about connections.

So, last week we talked about sensory diets, why I don’t use them, and what I do instead.  Check out that episode if you haven’t had a chance to listen to that, because when I was finishing up that episode, I briefly talked about this idea of interoception.  So today, I wanted to dig into this idea of interoception a little bit more.  Specifically, what it is, how it can affect our children, and what we can do to help build their interoception.

What is interoception?

So, let’s start at the beginning.  A book that I really love about his topic is called Interoception, The Eighth Sensory System by Kelly Mahler, MS, OTR/L. So let’s review all eight sensory systems, real quick, shall we:

1. Tactile system (touch)
2. Auditory system (hearing)
3. Visual system (sight)
4. Gustatory System (taste)
5. Olfactory System (smell)
6. Proprioceptive System (body awareness)
7. Vestibular System (balance & movement awareness)
8. Interoceptive System (internal awareness)

In Kelly Mahler’s book, she states “interoception allows us to “feel” our internal organs and skin and gives information regarding the internal state or condition of our body.  For example, the interoceptive system helps us feel many important sensations, such as pain, body temperature, itch, sexual arousal, hunger, thirst, heart rate, breathing rates, muscle tension, pleasant touch, sleepiness, and when we need to use the bathroom.”

Interoception, The Eighth Sensory System by Kelly Mahler, MS, OTR/L

Many of you might already be thinking of things that your child has a hard time with.  For example, maybe they don’t seem to be able to tell when they are thirsty or it has taken them longer to be potty trained.  Maybe they don’t seem to be able to know when they are tired or when you think something should have hurt, they don’t even seem to notice.

Whatever might be the case for your child, having a better understanding what it might feel like to be them and knowing what you can do to improve this system can be very helpful.

What if my child does not have good interoception?

The part of the brain that receives all of this information from our “insides”, so to speak, allows us to answer the question what is going on with my body.  Understanding what is going on with our “internal world” helps us to know our emotions and how we are feeling.

Let me explain this concept a little more.  Think about how you know how you are feeling.  For example, when I’m anxious, I know because I can feel my heart start to race and my breathing will be shallow.  My muscles, especially my upper shoulders, will feel very tight.  My mind will have racing thoughts.

If I had a hard time feeling those things, how would I know if I was anxious?  How would I know what to do to calm myself down?  When would I know that I needed a break or should ask for help?  The answer is I wouldn’t, so then it is really no surprise when our children go from what seems like 0 to 100 at a flip of a switch.  When in reality, they were having a difficult time managing the situation for a while but most likely couldn’t even tell until they were in a meltdown. 

What does this feel like for us?  Frustrating!  Why doesn’t our child just ask for help?  Why can’t they tell me when they are hungry?  Also, why do they not seem to have an activity level that seems to match that of the situation.

When it comes right down to it, our interoception plays a huge role in how we self-regulate. 

Or rather how we keep an internal balance or even keel.  It’s when we get clear signals and understand the signals from our body that we know how to act.  Without this ability, we would have a hard time knowing when to stop or start an activity that would make us feel better or what action to take.  Either that or our child might develop very maladaptive behaviors like hitting or head banging attempting to get their body to feel better.

In the book Interoception, the Eight Sensory Sensory, Mahler also explains that if you have poor interoception you will have a hard time being able to follow your intuition.  So if your child tends to be very logical in their thinking you may be starting to understand why.  But, being so logical about everything takes a ton of energy so what do so many of our kids do to deal with such a zap of energy?  They prefer sameness and have a hard time keeping up with a super-fast conversation that others might be having.

Now let’s think about how having decreased awareness of what are body is feeling leads to having decreased ability to keep an even keel which leads to not being able to feel our emotions which leads to having to be logical about everything which would then lead to not understanding other people’s emotions.

We feel empathy for other people, because we know how if feels for us to feel the same way.  If we don’t know how they feel we have a very difficult time understanding what they are dealing with. 

Now let’s go a step further and talk about how important it is for us to understand the different between harmful touch and a social touch.  There is more than one system involved here, but the interoceptive system plays a huge role in this.  Understanding social touch helps us to bond with others and to from relationships.  It helps us to enjoy those relationships. 

How can I improve my child’s interoception?

So, I think that it is about time that we talk about what we can do to help our children improve their interoceptive system if a lot of this is ringing true for your child.

I am going to share basically two different approaches that you can use here.  One is more for immediate use and the other is an approach to improve the systems function.  Also, I am talking about these with the assumption that doctors have already ruled out any medical concerns.

1.  Use strategies to help them with specific goals that you might have for them. 
   • Schedules: Let’s look at the example trying to help your child with potty training.  You might observe when they seem to have accidents to figure out a pattern and then just have them go to the bathroom based on those intervals. 
   • Build-in regular breaks: Maybe you observe that they usually have meltdowns after doing a difficult task after 10 minutes.  You might decide that it would be better to take a break after 7 minutes, for example, and do things that are very calming.  Then after they have had enough time to relax their bodies you would return to the activity.

There are a lot of examples for this area, but essentially, I want you to think about one goal that you have for your child.  Then start thinking about what might make it easier or simpler for your child.  Ultimately, you want your child to be successful.  Once they experience success, then you can think of what your next baby step might be. 

Now let’s start talking about how we can improve the information that our body receives that this system.

1. Do mindfulness activities if you can.  I love Sitting Like a Frog or mediations apps that kids can listen to.  Also, gonoodle.com has some great relaxation activities as well.  My son has always loved the one where he gets to pretend that he is melting.
2. Start naming what you notice about your child.  For example, you might say, “your shoulders seem really tense” and/or “your heart feels like it is beating really fast.  Then you might say, “when my body feels like that sometimes I feel angry”.   
3. Use an oximeter or something that can measure heart rate (go low tech if you have to and just feel your heart).  Have fun experimenting with what makes their heart rate go faster and what makes it slow down.  Have them guess what might change their heart rate if they can.  It might surprise you with what they think.  I love pointing out that they can do things that help control how their body feels too.  You could use his same concept with their breathing.
4. Squeeze and relax.  Have them squeeze their muscles really tight and then relax.  Have them do this several times. 
5. Go through different parts of their bodies and work on identifying what is going on in each body part.  For example, pay attention to their lungs, heart, brain, muscles, and stomach.

These are just a few ideas, but if this is something that you really want to delve into even more I definitely recommend you getting Kelly Mahler’s book.  The other thing I really want to mention here is that it is completely possible to improve your child’s interoceptive system.  Our brains are amazing and changes can and do happen!  But keep in mind that these changes do not happen overnight.  Think baby steps and that understanding what is feels like for your child is key. 

Candice Curtis is a licensed Occupational Therapist and the founder of Integrate Family. She is passionate about helping and empowering parents and their children.  Candice has advanced postgraduate training in theory, assessment, interpretation and treatment in Ayers Sensory Integration.  She is a Certified Autism Specialist with expertise in sensory processing, coordination disorders, learning disorders and executive functioning.  Candice also has 2 boys of her own at home, one of which is Autistic. Learn more about her here.