How I Develop My Children's Sense of Interoception

One of the things I have learnt on our autism journey thus far is that you never stop learning. Never!

Since O started her therapy sessions, we have begun yet another learning journey.

Ever since O started Kindy, we have always struggled to get her to drink water regularly. The issue with not drinking enough water or eating enough food throughout the day leads to other more serious complications. On more occasions than I would like, we have ended up in the emergency department of our local hospital with a very dehydrated child.

It was only in talking to O’s key therapist and the school age services coordinator that we realized that perhaps, just perhaps, O’s sense of interoception hasn’t fully developed.

I can now hear you asking, what on earth is interoception?

First we need to go back to basics. We all know about the five senses: hearing, sight, smell, touch and taste. But there are three others that are considered our hidden senses. Senses that we don’t consciously think about or are aware of on a daily basis.

The sixth sense is our vestibular sense — this sense provides our bodies with information as to where our head and body are in space. It helps us keep our balance as we move about.

Then we have the seventh sense which is proprioception — this is our body sense that tells us where our body is in relation to the rest of us. It also tells us how much force to exert when performing different activities like hugging someone, shaking hands, cracking an egg open and so on.

This is a relatively unheard of internal part of the sensory system and consists of all of the internal sensations we may feel on a daily basis when we’re hungry, thirsty, anxious, nervous or when we need to go to the bathroom. Any sensations that originate from within our bodies stems from the sense of interoception. Receptors in our body organs and skin are constantly sending information about the inside of our bodies to our brain.

Our sense of interoception is always there in the background and it isn’t something that we are generally consciously aware of.

In some individuals, particularly those who have sensory processing difficulties, this hidden sense may still be developing. And as with sensory processing difficulties, individuals may be under-responsive, over-responsive or a combination of both.

Some specialists consider that individuals with sensory processing difficulties may not know how to verbally label the data that their brains receive from the interoceptive sense. If they are not receiving enough data, the sensations they receive may be confusing. And likewise, if their brain is receiving too much data from the interoceptive sense, the sensations may become overwhelming.

In O not feeling the need to drink water regularly, in essence means that this part of her interoception sense is under-responsive — she simply isn’t receiving enough data to register that she is thirsty.

In O being in a constant state of anxiety at times means this part of her interoception sense is over-responsive. Her brain is receiving too much information and the data becomes a distraction so she is unable to focus on anything else and enters into an anxious state.

The tricky thing about our sense of interoception is that the data it sends to our brain is required for a range of basic and advanced functions. These functions range from breathing, being hungry or bring full, needing to go to the bathroom, being aware of our own emotions, being able to manage our own emotions and everything else in between.

So it makes sense then that if a child’s sense of interoception is still developing, then they may struggle with recognising and responding appropriately to their own emotions and those of others.

If an individual’s brain has difficulties in making sense of the information it receives, then the individual may not be tuned into their internal body cues that assist others to interpret emotions. They may have difficulty “feeling” the different emotions they experience. If an individual is not able to interpret their own different body sensations, then they may have difficulty in identifying their own emotions and the emotions in others.

So how can we help children whose sense of interoception may still be developing?

One of the activities O’s key therapist has been working on is labelling different emotions and talking about what some of the external and internal feelings she may feel that are associated with these emotions. We have quite a number of body outlines with different sensations written around them: anger, nervous, happy, sad… you get the picture. This has been incredibly beneficial and very effective as O is now starting to recognize the early warning signs of her different emotions and can now verbally tell us how she is starting to feel.

Earlier this year, I developed a social story called “My Book About My Feelings” to assist O in labelling her own emotions. The story helps her identify how she felt inside when she was sad or anxious.

We regularly read books and talk about how the characters might be feeling in particular situations.

When we see our kids experiencing different emotions, we verbally assist them to label their emotions, “Oh you look very excited…..” or “I can see that you are becoming angry/frustrated by ……………” This not only assists them to label their own emotions, but it also provides them with the appropriate language so that the next time, they may be able to verbally express themselves.

We also verbally label our own emotions and our internal sensations to the kids. If they recognize they too experience these internal sensations, then they will begin to connect the dots!

Interoception issues are not as well known as other sensory processing difficulties. As such, medical professionals are still developing strategies to further develop this sense in those who need it.

The great thing about being on a learning journey with our kids is that as we are aware and have a basic understanding of the possible causes behind behaviors and/or functional limitations, we are better able to help. Just having an awareness of the sense of interoception and the implications of this sense still developing means we are able to trial different strategies to see what works best for the kids. It means that we are more understanding when we see them struggle with skills that everyone seems to take for granted.

So the next time you see a child who can’t seem to get the hang of toilet training, or they never seem hungry or thirsty, or they fly off the handle at the drop of a hat, keep in mind that perhaps their sense of interoception is still developing.

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