Understanding Interoception: The "Hidden Sense" That Impacts Everyday Life

When most people think about senses, the "big five" come to mind—sight, sound, touch, taste, and smell. But did you know there’s another sense working behind the scenes that’s just as vital? It’s called interoception, and it plays a crucial role in how we perceive, regulate, and respond to what’s happening inside our bodies.

For children, particularly those with neurodiverse conditions like Autism Spectrum Disorder (ASD), Sensory Processing Disorder (SPD), or ADHD, interoception challenges can significantly impact their ability to manage emotions, behaviours, and even basic needs. Understanding interoceptive awareness—and learning how occupational therapy can support it— is a game changer for both therapists and parents.

What is Interoception?

Interoception refers to our ability to sense what’s happening inside our bodies. This includes signals like:

• A growling stomach signaling hunger.

• A racing heart indicating excitement or anxiety.

• Sweaty palms linked to nervousness.

• A full bladder needing attention.

But interoception goes beyond physical sensations—it helps us connect these signals to emotions and act accordingly. For instance, feeling your stomach churn might lead you to recognize nervousness before a big presentation, or realising thirst prompts you to hydrate.

Why is Interoception Important?

Interoception doesn’t just help us meet physical needs; it also plays a key role in emotional regulation and self-awareness. When this sense is functioning well, children can identify their body’s signals and respond in ways that bring them comfort or balance.

However, some children experience differences in interoceptive processing, which can affect how they interpret and respond to internal sensations.

Interoceptive Challenges: Hypersensitivity vs. Hyposensitivity

• Hypersensitivity to Interoceptive Input
  Children with hypersensitivity may experience routine body signals as overwhelming or distressing. For example, hunger might feel painful, or a racing heart might feel frightening. These intense sensations can lead to heightened anxiety, meltdowns, or difficulty concentrating as they become preoccupied with their internal stimuli.

• Hyposensitivity to Interoceptive Input
  Conversely, children with hyposensitivity may struggle to notice body signals at all. This can result in missing cues like hunger, thirst, or even the need to use the bathroom. Without recognizing these sensations, a child may appear to “act out” suddenly, skip meals, or struggle with potty training.

Signs of Interoceptive Differences

Some common indicators that a child may have interoception differences include:

• Difficulty recognising when they are hungry, full, or thirsty.

• Challenges with toilet training, both during the day and at night.

• Difficulty identifying when they are tired.

• Being overly sensitive or under-sensitive to pain.

• Trouble pinpointing symptoms of illness.

• Difficulty identifying emotions in themselves and others.

• Struggling to recognize signs of distress before it leads to a meltdown.

If these signs resonate, working with a skilled occupational therapist experienced in interoception support can make a meaningful difference.

Can Interoception Be Improved?

The great news is that interoceptive awareness can be supported and strengthened through targeted strategies! Here are some simple yet effective ways therapists and parents can help:

Encourage Interoceptive Attention
Prompt children to notice their own body signals, like:

• “How does your stomach feel after lunch?”

• “Do your legs feel tired after running?”

Use Interoceptive Language
Regularly label body sensations during everyday activities. For example:

• “My hands feel warm after washing them with hot water.”

• “Your heart is beating fast—maybe you’re excited!”

Highlight Body Language and Emotions
Help children link physical sensations with emotional states. For example:

• “Your fists are clenched, and your face looks tense—are you feeling frustrated?”

Body Mapping
Use visuals to help children identify where they feel sensations in their bodies and what they mean.

Incorporate Mindfulness Activities
Practices like meditation, yoga, and deep breathing help children tune into their body signals and learn self-regulation skills.

Heavy Work and Tummy Time Activities
These can provide proprioceptive input and help children regulate their internal states.

Role-Playing Scenarios
Practice what to do when certain sensations arise. For example:

• “If your stomach growls during school, what could you do?”

Why Does Interoception Matter in Therapy?

For occupational therapists, addressing interoception is key to supporting a child’s self-regulation, emotional awareness, and independence. By incorporating interoceptive strategies into therapy sessions, we can empower children to better understand and respond to their bodies, helping them navigate daily life with greater confidence and comfort.