Interoception With Laura Petix

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In the realm of occupational therapy and child development, certain concepts like sensory processing and emotional regulation are widely discussed. However, there’s a lesser-known but crucial element called interoception that often goes unnoticed. In a recent podcast interview with Laura Petix of The OT Butterfly, we chatted about interoception, uncovering its significance in the lives of neurodivergent children. Read on to discover what we talked about! * Information in this blog post is based on the interview with Laura Petix.

Listen to the podcast episode here

What is Interoception?

Interoception is the missing link to emotional regulation. As caregivers and educators of neurodivergent kids, emotional regulation is probably one of the top areas of need that these kids need support with. We spend a lot of time teaching kids feeling words and noticing facial expressions. The piece that a lot of parents and educators are missing is understanding the interoception piece, which is really what drives a lot of the behaviors that we’re seeing around emotions. So interoception is one of the eight senses and it is responsible for informing our brain of internal sensations.

If you think about when you feel hungry and you feel your tummy rumbling, that’s interoception. When you notice the signs that you have to go potty, that is interoception. When you can feel your heart racing without putting your hand on your chest, that’s interoception. If you are on a rollercoaster and your tummy drops, that’s interoception. All those internal sensations are important for informing our brain about our physiological state. Every emotion we experience as humans has an interoception sensation that’s linked to it. Some of us notice them, some of us don’t notice them, and some of us notice them more intensely. Neurodivergent kids can be super sensitive to interoception sensations or they may have a higher threshold. They may miss the interoception sensations or may react differently to emotional situations.

Understanding Interoception’s Impact

Neurodivergent children, who often struggle with emotional regulation, may exhibit behaviors stemming from interoceptive challenges. Some may be hypersensitive to internal sensations, leading to heightened emotional responses, while others may have a high threshold, resulting in a disconnect from their bodily cues. This discrepancy can significantly impact various aspects of their lives, including potty training, feeding, and emotional well-being.

For me, I know specifically I am startled by sudden sound, but I don’t like what those internal sensations feel like when my stomach drops, I can’t catch my breath, and I have to put my hand on my heart and take a couple minutes to come back down.

That’s the interoception piece that’s trying to trigger my sympathetic nervous system, my fight or flight. I need to actively pause that by using my parasympathetic nervous system, which is the rest and digest by doing really slow exhales, grounding techniques, all of that to really tell my nervous system, you’re safe, you are scared, but this is not an emergency. You’re not in danger. If I couldn’t access those tools or if I was a child who didn’t know, I would just spiral into sympathetic nervous system and have a meltdown or be completely dysregulated the rest of the day from one little startle. That can happen to so many of our kids.

Interoception and Potty Training

Interoceptive difficulties can manifest during potty training. Hypersensitive children may interpret the slightest urge to urinate as an immediate need, while those with low registration may struggle to recognize when they need to go, leading to accidents or urinary tract issues. By understanding these nuances, caregivers can approach potty training with empathy and tailored support strategies.

Navigating Interoception in Daily Life

Interoception extends beyond bodily functions; it influences how children perceive and respond to emotions. By acknowledging and validating their internal sensations, caregivers can help children develop awareness and regulation skills. Through activities that encourage self-awareness and sensory exploration, children can learn to recognize and manage their physiological responses effectively.

We’ve all mastered the top five sensory systems and now a lot people recognize sensory needs to move, like big body movements. Interoception is the last one for people to really recognize and get on board with. It is so discreet because no one can see it and it can be disguised as behavior. So when we’re relating to hunger, potty training, emotional regulation, the first thing people think of is top-down approaches and behavioral approaches. Helping them problem solve through their anger, helping them use a potty schedule, helping them use a break pass to go outside for this when in reality it is interoception based.

How Do We Teach Awareness?

The first step is helping your child become aware of those sensations and notice those sensations. Kelly Mahler created a curriculum for therapists full of activities to help. Step one is helping them notice it. So the next time they independently say they have to pee, you can stop them and say, “wait, how do you know you have to pee? What’s telling you? Where do you feel it in your body?” If they point to anywhere, even if they’re pointing to their knee, whatever they say, we’re gonna say, “Great, now you know, when you feel something there, it means you have to go to the bathroom”. We’re not going to correct them and say “no, don’t you feel it here”, because we all experience interoception differently.

We probably have some similarities in how we experience hunger, but anxiety, frustration, anger, even potty cues, can be felt in other places. So we say, “how did you know you had to go to the potty? Or how did you know you were hungry? Where did you feel it?” Maybe they localize it, they point to it and we keep writing that down. Then being able to help them create a plan of what they need and what happens after. Stay present in how they want to describe it, notice it and try to piece the regulatory action that helped eliminate that sensation.

Creating a Sensory Lifestyle:

Observe your child every day. Step back and pretend like you’re a scientist and take notes. Write down what the behaviors, actions and movements are that your child tends to do. Are those actions making them more regulated? Are they able to participate in the activity or is it taking away from it?

Children have a mix of needs. Developing a sensory lifestyle or support plan is essential for addressing interoceptive needs comprehensively. By observing a child’s behaviors and identifying patterns related to sensory preferences, caregivers can curate a toolbox of strategies tailored to their unique requirements. Whether it’s providing sensory-rich environments, implementing sensory breaks, or incorporating sensory activities into daily routines, proactive support can promote regulation and well-being.

If you use visual supports in your classroom or home, you are going to want to sign up for this free Visual Supports Starter Set ASAP! Click here to have one sent to your inbox. Also, be sure to read more about visual supports and how they can help autistic children here

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