What is Interoception?

Having a basic understanding of interoception can help us support kids’ sensory processing needs.

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When you think of sensory processing, you probably think of hearing, sight, smell, taste, and touch, right?  And, most of you also know about two other important sensory systems – the vestibular system, and the proprioceptive system.

But what if we told you that there is yet another sensory system that can have a huge impact on kids’ self-regulation, behavior, and overall functioning?

Interoception is probably the least familiar sensory system to most of us, but knowing the basics about this aspect of sensory processing can give us a more complete understanding of a child’s behaviors and ability to function how we can best support them. Read on to learn more!

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What is Interoception?

Interoception refers to our perception of what is going on inside our bodies and is responsible for feelings of hunger, thirst, sickness, pain, having to go to the bathroom, tiredness, temperature, itch, and other internal sensations.

What’s even more interesting about interoception is that it goes deeper than physical sensations because – as with all of our sensory systems – when our brains receive these internal signals, we interpret, attend to, and analyze them (1).  So interoception is also associated with our sense of well-being, mood, and emotional regulation.

A helpful way to think about it is that interoception is how we answer the question, “Am I okay?”  If those internal signals tell us that yes, we are okay (we’re not in pain, we’re not hungry, we don’t have an urgent need to use the restroom…), then we go about our daily activities with a general sense of well-being and ease.

However, if we ask ourselves this question and we’re answered with a different set of signals (heart palpitations, nausea, a headache) – we respond in an entirely different way.  We may feel anxious, upset, or even a sense of panic.

What does it look like when a child has issues with interoceptive processing?

Picking apart the exact causes of kids’ sensory-related behaviors can be extremely complex.  And throwing interoception into the mix definitely adds yet another layer of complexity.   But consideration of this sensory system can be invaluable as we work with children who struggle with aspects of development like potty training, feeding, attention, and more.

Hypersensitivity to interoceptive input

As with the other sensory systems, it’s possible that some children may experience a heightened sensitivity to the internal sensations in the body.  In one study, it was suggested that children with autism may have a heightened sensitivity to internal cues, specifically to their heartbeat, and it was proposed that their “attentional resources are disproportionately allocated to internal, rather than external, sensory cues.” (2) *

For children with hypersensitivity to interoceptive input, typical everyday sensations like hunger or having to go to the bathroom, may be extremely distracting and even painful. Hypersensitivity to interoceptive input may result in difficulty maintaining attention to tasks if the child is preoccupied with the internal stimuli.

What’s more, studies have highlighted “the dependence of emotional state on bodily context” (4).  So the physical “overreactions” these children may experience in response to internal stimuli may also result in extreme emotional responses.  Children who are hypersensitive to interoceptive input may experience anxiety, meltdowns, and other negative behaviors for apparently no reason, when actually they are responding to the intensity of these internal sensations.

Hyposensitivity to interoceptive input

On the other hand, some children may be less sensitive to interoceptive input – to the extent that they do not receive cues from these internal sensations at all.  While hypersensitive children may be receiving too much input from the interoceptive system, hyposensitive children may not be getting enough information from their bodies.

They may not feel when they have to go to the bathroom, resulting in accidents or constipation.  They may never feel full after eating – or they may never feel hungry in the first place.  Because they are under-responsive to internal cues, they may not be able to interpret or respond to pain or temperature in a functional way, which can result in safety issues.

So when we see kids who can’t attend, who seem to fly off the handle without warning, who can’t get the hang of potty training, or who never seem hungry or thirsty…it’s possible that they are struggling with interoceptive processing (and/or other sensory processing issues).  They may be extremely sensitive to this internal input, or they may not be picking up on the important interoceptive signals they need to function.

How can we support kids who struggle with interoception?

While there doesn’t appear to be conclusive evidence pointing to one specific technique to support the development of healthy interoceptive processing in children, researchers have suggested that mindfulness activities like meditation and “reflection on interoceptive processes” may have an effect on regulating the mind’s attentional and emotional response to interoceptive input (5) and that “skillful attention to interoceptive sensation may improve self-regulation” (5).

Research on applying any specific “interoceptive training” techniques to children in clinical, home, or school-based settings is very scarce.  But based on what we already know about sensory processing, mindfulness techniques, and social emotional development, it’s possible that some of our tried and true strategies in these areas may also support interoceptive functioning in kids.

Strategies for Supporting Interoceptive Functioning

Common calming sensory techniques for children

-Repetitive, rhythmic vestibular input (swaying, swinging, rocking)

-Deep pressure input

-Heavy work activities

–Find more calming sensory strategies here.

Common alerting sensory techniques

-Providing more intense, frequent sensory input to help promote awareness

-Active movement breaks

-Frequent changes in position

-Find more alerting sensory strategies here.

Mindfulness activities

-Body scanning visualizations – bringing awareness and attention to the different parts of the body and referring to the sensations of breath, heartbeat, gurgling stomach, the weight of the limbs, etc.

-Meditation

-Yoga

Language and communication strategies

-Providing kids with the language to describe what they are feeling

-Giving kids mechanisms and opportunities to communicate these internal sensations (using visual prompts, picture cues, communication devices).

Social Emotional Teaching Strategies

-Helping kids recognize, identify, and communicate feelings and emotions

-Expressing our own emotions clearly and modeling adaptive responses to our emotions

-Verbally labeling children’s emotions as we see them at home, in the classroom, or in therapy

-Playing games and reading books related to emotions and feelings

These strategies may be helpful for children who are cognitively able to participate and engage in them.  They may be difficult or impossible for children who have significant cognitive limitations.

However, as professionals and parents, just having an understanding and awareness of interoception as one of the possible causes behind a child’s behaviors and functional limitations can be very helpful in gaining a more complete picture of a child’s unique and complex sensory makeup.

We would love to hear from you!  What are we missing in this discussion of interoception?  Are you aware of new research or techniques that might contribute to our understanding of this complex aspect of sensory processing?  

*Other studies have indicated that children with autism struggle with interpreting interoceptive input because they have such difficulty with identifying and describing their emotions (4).

1 – Farb, N. A., Daubenmier, J. J., Price, C. J., Gard, T., Kerr, C. E., Dunn, B. D., et al. (2015).Interoception, contemplative practice, and health. Front. Psychol. 6:763

2 – Kimberly B. Schauder, Lisa E. Mash, Lauren K. Bryant, Carissa J. Cascio, Interoceptive ability and body awareness in autism spectrum disorder, Journal of Experimental Child Psychology, Volume 131, March 2015, Pages 193-200

3 – Mallorquí-Bagué, N., Garfinkel, S. N., Engels, M., Eccles, J. A., Pailhez, G., Bulbena, A., & Critchley, H. D. (2014). Neuroimaging and psychophysiological investigation of the link between anxiety, enhanced affective reactivity and interoception in people with joint hypermobility. Frontiers in Psychology, 5, 1162.

4 – Shah P, Hall R, Catmur C, Bird G. 2016 Alexithymia, not autism, is associated with impaired interoception. Cortex 81, 215–220.

5 – Farb, N., Daubenmier, J., Price, C. J., Gard, T., Kerr, C., Dunn, B. D., … Mehling, W. E. (2015). Interoception, contemplative practice, and health. Frontiers in Psychology, 6, 763.

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Claire Heffron

Claire Heffron is co-author at The Inspired Treehouse and a pediatric occupational therapist in a preschool/primary school setting. She began her career with a bachelor's degree in magazine journalism but quickly changed course to pursue graduate studies in occupational therapy. She has been practicing therapy for 10 years in public and specialized preschool/primary school settings. She is a mom to three funny, noisy boys and relies on yoga, good food, and time outside to bring her back to center.

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