While experts debate just how many senses a human has, most people know the primary five: Sight, hearing, smell, taste, and touch. At RiverView Health, members of the Occupational Therapy Team now offer pediatric therapy for a lesser-known, but just as important sense, interoception.
Interoception is the sense that helps you understand and feel what’s going on inside your body as receptors inside your organs send that information to your brain. For example, you may feel hunger pains and a dry mouth when you are thirsty.
However, the brain may have trouble making sense of that critical information for children with sensory processing issues, leading to problems with activities like toilet training because the child doesn’t understand when their bladder is full. A child lacking interoception may not know when they are hot or cold, in pain, or about to vomit.
Lack of interoception sense may also cause a child to act out in aggression, cry or scream uncontrollably, or show other signs of sensory dysregulation because they are confused by the body’s signals and don’t understand what to do to make themselves comfortable.
RiverView Services
Maddie Engelstad, MOTR/L, Stacy Spray, OTD, OTR/L, and Marrisa Jevne, COTA, are specially trained in the interoception curriculum and began offering the new therapy to pediatric patients at RiverView in the fall of 2023.”
“The primary issues or deficits I see in patients who benefit from interoception skill building are those who are having a hard time connecting their brain and body," shared Engelstad” “Usually, I see this in patients with Autism Spectrum Disorder, ADHD/ADD, Sensory Processing Disorder, or any child that has difficulty with emotional regulation. The other population that has seen this benefit is patients with bladder and bowel management difficulties and learning to understand feelings of urgency and pressure. Those internal signs don’t always make sense, or we may forget about being busy playing and learning”.”
Suppose interoception therapy is determined appropriate for the patient after an evaluation, caregiver input, and clinical observations. In that case, the therapists conduct” “experiments” about each part of the body, shared Spray, including outside (hands/fingers, feet/toes, mouth, eyes, ears, nose, voice, cheeks, skin) and inside (muscles, lungs, heart, brain/head, stomach, bladder) the body. An example Spray shared for the mouth is having the child suck on an ice cube for 5 seconds, then describe how that made their mouth feel. The child can pick from a list of words or create their own if they like.”
“The children I have seen who have shown improvement with their interoception skills are identifying how their body is feeling more independently and recognizing what the feeling means for the “Spray reported” “For example, a child may notice their heart is going faster than normal and recognize that this is because they are excited or anxious. They are then able to determine an appropriate action to take to assist with regulating their heart rate. The goal is for the child to make these connections with increased independence; it’s so fun to see when they are in therapy sessions and making the connections with decreased assistance over time. It’s even more exciting when the parents come to therapy sessions with comments, such as he told me yesterday that he needed a drink of water because he noticed his mouth was feeling dry, demonstrating the interoception curriculum is carrying over into daily life situations.”
Engelstad said the curriculum is excellent for patients as young as 4-5 years of age and up to 12 and 13 years old” “They start to understand why their body feels a certain way and how that relates to their emotion,” Engelstad stated” “The experiments bring to light sensations that they have felt, but didn’t know what those sensations meant weren’t able to relate the sensation to a particular emotion.”
Jevne also reported that through the therapy, she had seen significant improvements in the children’s ability to identify their body signals to help them recognize their emotions. Implementing Interoception Curriculum at Every Level
While Engelstad said she started offering the therapy in October of 2023, she's found it helpful in other therapies she provides and has integrated it into all of her patient sessions, where directly focusing on interoception skills or other therapies that focus on self-regulation, coping skills, and frustration tolerance building.
You can do many activities with children to help increase their interoception skills, including asking them questions about how they are feeling and discussing those feelings or reading the children’s books on topics like emotions, toilet training, and problem-solving.
If you have concerns about your child’s development, talk to their primary care provider or calRiverView’s Rehab Services Department at 281.9463 for more information on interoception therapy. The Rehab Services Team also offers free developmental screenings if you have concerns about your child’s development.
