Interoception: The Eighth Sense

Our sensory system is how we experience the world around us, and when we have difficulty processing one or more of these senses, our daily experiences can be hugely impacted. Children also use their senses to take in the world around them and learn new skills, whether through watching a bubble float by with their eyes, feeling gooey slime squish between their fingers, or tasting that delicious piece of cake with their tongue. While some of the senses are better known, there are others that are “hidden,” but equally as important in your child’s development. Some children have difficulty processing sensory information and producing a response that is appropriate, which can be seen through a variety of challenges in completing important daily activities. Understanding what our senses do for functioning is the first step in improving our ability to process them!

What is interoception?

It is likely that you learned about the “five senses” sometime early in your life: touch, taste, smell, sight, and hearing. These senses help you initially interact with the world around you and are important in helping you participate in everyday activities as an infant and young child. As you got older, you may have learned of the next two senses that are not as obvious but still very important to daily functioning: the proprioceptive and vestibular sense. Proprioception is the sense that identifies the position of your body in space with the use of receptors in your joints and muscles, and the vestibular sense helps us with movement, balance, and controlling our posture.

Interoception is the eighth sense we have; it is often called the “hidden sense” because it is not something we can see, but what we feel on the inside of our bodies. Imagine it is 2:00 in the afternoon and you have not eaten since 7:00 in the morning. Your stomach starts to make a growling noise. That is your interoceptive system working to let you know that you are hungry and that your body needs food to maintain a balanced state. When responding appropriately, you would recognize that sound and feeling to mean hunger, and you may go to the kitchen and get a snack.

Our interoceptive sense allows us to feel important body functions like hunger, pain, nausea, itch, needing to use the bathroom, coldness, and even emotional states such as nervousness, fear, or excitement. This sense uses internal signals that tell us how our body is feeling and can give clues to how we can respond to restore balance and find a place of comfort. Our bodies want to feel regulated, and how we get there may be different for everyone.

What does it look like when a child has difficulty with the interoceptive sense?

When the interoceptive sense is not processed appropriately, your child may have difficulty understanding what the signals inside of his/her body are trying to communicate and then will have difficulty responding appropriately to these messages.

Generally, this means challenges with:

  • Bedwetting, constipation, and frequent accidents
  • Identifying appropriate ways to dress for the weather/temperature
  • Not being able to identify hunger, thirst, sickness, pain
  • Self-regulation, self-awareness, and emotional outbursts
  • Having flexible thoughts and behaviors
  • Problem-solving
  • Social skills and participation

Self-regulation, or the ability to monitor and manage your emotions and behaviors, is a vastly important aspect to consider with your child who may be struggling with interoception. For example, your child may not be able to feel or recognize getting angry; that is, a faster heartbeat, the face getting hot, or muscles tensing. Your child will then have difficulty identifying that these feelings mean anger, possibly not even until the emotion has already produced an inappropriate response. Without understanding and being aware of how these body sensations are making us feel, it will be difficult to identify the emotion being experienced and react in a way that is appropriate.

How can occupational therapists address interoception skills in children?

As daily occupations (i.e. using the bathroom, dressing for the weather, interacting with friends) are often affected by our understanding of our internal body sense, occupational therapists have a role in working with children who may have difficulty with the interoceptive sense. Occupational therapists (OTs) at PlayWorks follow guidelines from the Interoception Curriculum, a program designed by Kelly Mahler, a licensed occupational therapist and expert in interoception.

Using a step-by-step framework, OTs work to improve awareness of sensations within the body by introducing body experiments and body checks. These activities seek to improve your child’s understanding of how his/her body feels and can enable him/her to respond appropriately to improve participation in daily activities. Following this curriculum, OTs may also use a visual representation of the body to aid in recognizing and understanding body signs. This can be accomplished by using a visual drawing of a person with different body parts, combined with a list of different sensations or describing words. This will enable your child to practice matching the descriptor words to different body parts to increase understanding and connection of internal body cues and daily activities.

What can I do to support interoception in my child?

While interoception should be addressed in therapy, you can also support these challenges while at home. It will be helpful to start labeling body language as you notice it during different activities. For example, you can say, “I see that your breathing is getting heavy and your face has become a little red. I think you might be feeling angry.” This may help to link specific body language to emotions that they are feeling.

Additionally, you can try out some mindfulness activities, such as meditation, yoga, or reading a book centered around being mindful. While doing so, you can point out or ask how their body is feeling when they are doing these different activities to bring awareness to internal body cues. While this may be a challenging sense to understand for some children, there are many ways we can work with you and your child to increase his/her knowledge and recognition of these cues to improve participation in daily activities!

Questions or concerns?

If you have questions or concerns about your child’s interoceptive sense, please contact us at info@playworkschicago.com or 773-332-9439.

 

Molly Ross

Occupational Therapy Student Intern

 

References:

Interoception: The Eighth Sensory System (2016). Retrieved from https://docs.wixstatic.com/ugd/b303b5_ab07aaedc04c45b3a96e519fc262ecd1.pdf

Mahler, K., McLaughlin, E., & Anson, D. (2020). Interoception Across Varying Degrees of Mental Wellness. American Journal of Occupational Therapy74(4_Supplement_1), 7411505251p1-7411505251p1. https://doi.org/10.5014/ajot.2020.74S1-PO9513

 

Photo Credit: Ketit Subiyanto via https://www.pexels.com

Home Bodies: Gross Motor Activities You Can Do at Home

What are gross motor skills?

Your child’s gross motor skills allow them take their first steps, play their favorite sports, and sit upright in their chair at school. Gross motor skills involve stabilization of our large muscle groups and active movement of our whole body to carry out these meaningful activities. In order to develop age-appropriate gross motor skills your child will utilize the following body mechanisms: muscle strength, muscle tone, activity tolerance, motor planning, postural control, body awareness, balance, coordination, and proprioception (our sense our body position and body movement).  If your child is having difficulty with their gross motor skills, they may appear to be clumsy, have difficulty completing activities of daily living such as dressing, or avoid physical activity.

Laying the Foundation

In order to develop more refined skills, such as fine motor skills, your child will need to build a foundation of age-appropriate gross motor skills. For example, in order to complete fine motor tasks at school, your child must first demonstrate appropriate trunk strength and postural control in order to sit upright in their chair. Once your child develops appropriate trunk strength and postural control, he/she will need to develop gross motor shoulder stability in order to prevent his/her shoulder from moving when engaged in writing activities. It is when these gross motor abilities of trunk strength, postural control, and shoulder stability are present when your child is able to develop more refined skills. Our gross motor skills lay the foundation for the more sophisticated and intricate small muscle movements.

Home Work

In a literature review of fundamental movement skills conducted, researchers found a positive relationship between children’s development of gross motor skills and health benefits such as increased physical activity and decreased sedentary behavior*.

At-home gross motor activities are just a jump, skip, and a hop away:

  • Obstacle Course: indoor obstacle courses are a wonderful way to get your child crawling through tunnels, jumping over “lava,” and running to the finish line. This also provides additional opportunities for supplemental sensory input for increasing overall regulation!
  • Yoga: yoga is excellent for incorporating whole body movements, core strengthening, and increasing our sense of proprioception. In order to further develop our body awareness, have your child imitate yoga poses in front of a mirror in order to increase his/her understanding of how his/her body is positioned in space. Yogarilla cards are a great resource for various yoga poses in a fun format for your child.
  • Dance Party: join in on the fun with your child and throw a dance party! Choose action-based songs, such as “I’m Going on a Bear Hunt.” Incorporate action-based songs that involve activities requiring the use of both the upper and lower extremities to utilize your child’s motor planning and coordination skills.
  • Play Catch: a simple back and forth game of catch with either a ball, balloon, or bean bag can facilitate development of motor planning, body awareness, and bilateral coordination. Additionally, with the balloon allowing more time to move throughout space, encourage your child to keep it off the floor utilizing different body parts, such as their feet or even their elbows.
  • Simon Says: have your child participate in a gross motor version of Simon Says. For example, you can state, “Simon says jump up and down. Simon says touch your toes. Simon says stand on one leg.”
  • Animal Walks: completing animal walks such as bear walks, frog jumps, crab walks, etc. Your child might even want to create their own kind of animal walk!
  • Bubbles: blow bubbles and have your child pop them with a body part that you designate. Try to blow the bubbles on each side of his/her body in order to promote crossing their body.
  • Tummy Time: If your child is not yet walking, encouraging him/her to spend time on his/her stomach will allow him/her to bear weight onto their arms. For example, you can place your infant’s desired toys around them in a circle so he/she has to bear weight onto his/her arms to reach out for them. If your child is walking, increasing the amount of time your child is bearing weight on his/her arms such as in a crawling position or lying on his/her stomach strengthens his/her shoulders, arms, and hands for the development of more precise fine motor skills. This can be done by playing games or completing puzzles in an all-fours position or army crawling during transitions.
  • Clapping Games: using both hands in coordination to complete clapping games such as patty cake are a material-free way to practice gross motor skills such as bilateral coordination and motor planning.
  • Stand Up: create a vertical surface for your child’s arts and crafts activities. When standing and using a work station in front of him/her (such as a piece of paper taped on the wall) instead of below them, your child is actively engaging and strengthening the muscles in his/her shoulders, arms, and wrists to promote gross motor development.

Questions or concerns?

If you have questions or concerns about your child’s gross motor abilities, please contact us at info@playworkschicago.com or 773-332-9439.

Reagan Lockwood, MS, OTR/L
Occupational Therapist

*Reference: Lubans, D.R., Morgan, P.J., Cliff, D.P. et al. Sports Med (2010) 40: 1019. https://doi.org/10.2165/11536850-000000000-00000

Photo Credit: Photo by Julia Raasch on Unsplash