Understanding Interoception — The Hidden Sense
By Ema Bartolo ·
As an Occupational Therapist in Malta, I spend considerable time discussing the senses with parents. While most people recognize the five traditional senses, and many have learned about proprioception and vestibular senses, there exists another equally vital sense that remains far less understood: interoception.
Often termed the “hidden sense,” interoception operates entirely within the body. Grasping this concept can reveal explanations for numerous perplexing behaviors.
What Is Interoception?
Interoception represents the capacity to perceive internal bodily experiences. It signals when we are:
- Hungry or satisfied
- Thirsty
- Hot or cold
- Requiring bathroom use
- Fatigued or energized
- Experiencing pain or illness
- Undergoing emotional states — since emotions produce physical manifestations (stomach flutter, elevated heart rate, muscular tension)
When functioning optimally, interoception operates unconsciously. However, for numerous children, this internal signaling system operates less reliably.
What Happens When Interoception Is Difficult?
Toileting Difficulties
When children cannot consistently sense bladder fullness, toilet training becomes exceptionally challenging. Frequent accidents occur not through defiance, but because signals arrive too late. This represents one of the most prevalent interoception-related difficulties parents in Malta present.
Eating and Appetite
Children may not experience hunger — skipping meals unconsciously — or may fail to recognize satiation. Some struggle to recognize thirst, raising concerns during Malta’s warm season.
Emotional Regulation
This constitutes perhaps the most significant consequence. Children unable to detect preliminary physical indicators of emotions cannot manage these feelings before they intensify, producing seemingly sudden, overwhelming emotional reactions.
Temperature Regulation
A child lacking warmth sensation may neglect removing clothing. In Malta, where seasonal temperature fluctuations and contrasts between cooled interiors and warm exteriors are substantial, this presents recurring obstacles.
Pain Awareness
Some children demonstrate apparently elevated pain tolerance, while others demonstrate heightened sensitivity. Both may correlate with interoceptive processing variations.
Who Is Affected?
Interoceptive difficulties manifest particularly frequently among children with autism, ADHD, sensory processing disorder, anxiety, and developmental delays. Nevertheless, they can occur in any child.
How Occupational Therapy Supports Interoception
At WonderKids, we employ multiple approaches:
- Body check-ins: Teaching children to pause and observe internal sensations
- Matching sensations to words: Developing language for internal feelings
- Movement and heavy work: Physical activities producing distinct internal sensations which we help the child identify
- Mindfulness-based activities: Developmentally suitable exercises emphasizing inward attention
- Visual supports: Body diagrams and emotion-sensation correspondences
- Routine-based practice: Incorporating interoceptive check-ins throughout daily activities
Once parents comprehend interoception, numerous observations become clarified. Contact WonderKids on +356 77048650 or at info@wonderkids.mt.