Sunday, January 5, 2014

Interoception: The “Other” Sense

Of course, occupational therapists are familiar with the traditional senses: vision, hearing, smell, touch, taste. We are also knowledgeable about the vestibular and proprioceptive senses, but there’s an “eighth” sense that may not be as familiar to us…the interoceptive sense. This sense takes the sensory input from certain internal organs and shares the information from those organs with the central nervous system. The interoceptive system regulates body temperature, thirst, hunger, heart rate, digestion, and bowel and bladder functioning.

For a child with sensory processing problems, it’s possible that the interoceptive system is impaired. Consider the following issues that are often present in individuals with sensory processing challenges:

-       Difficulty regulating body temperature
-       Stomach issues (constipation or diarrhea)
-       Challenges with potty training (may not be able to feel when bladder is full)
-       Feeding issues (decreased awareness of fullness or hunger/thirst)
-       Respiration and/or heart rate sensitivities (too fast, too slow, or problems transitioning from being sedentary to exertion)

If your child has a sensory processing disorder and struggles with several of these issues, consult with your occupational therapist. There are therapy techniques and adaptive strategies that may be effective in addressing these challenges.


  1. What kinds of therapies would help these types of problems? When I think of occupational therapy, I always thought that it referred to hands-on activities that would help the mind. Since most of these functions seem to be hard to control (temperature, stomach issues, etc.), would the therapies include things like change in diet? Also, do occupational therapists look into underlying diseases? Some of these problems sound like symptoms of illness. Thanks for the information!

    Edith |

  2. I agree Edith. OT's would certainly report all findings to the physician. We are their eyes, ears and hands. We are well versed in physiology, neuro biological performance of the body and abnormal vs normal human development. We dont diagnose, though a seasoned therapist, like a nurse, will know what to report and include pertinent intrinsic and extrinsic environmentally related details that may contribute to provoking or inhibiting full healthy organ function. This specific 8th sense is new ish to me, but I have unofficially known and used this information throughout my career. We all have. But just like identifying autism, sensory related limitations, and other conditions, that is always the straight forward part for us. There are many objective sure fire solutions for many scenarios but also many solutions that must be identified with consideration for unique variables that contribute to each individual when it doesnt fit a typical clinical pathway. We may identify tools such as alarms as an adaptive means, or perhaps E stim modality or reflex integrative exercises such as "snow angels" to work on pelvic or lower spinal muscle strengthening if muscle imbalances are the cause or contributor for continence. In support for the pediatric urologist, neurologist, ortho, or primary care pediatrician we may know how to "coach the family" on what signs and details to track and log that may help the physician in examinations and differential diagnosing. The role of Occupatonal Therapy is quite broad. In a nutshell we address life activities, aka occupations such as play, sleep, self care, study, work, socialize, etc. We search to identify the obstacles to optimal performance for what a person needs and wants to do to live life at the fullest. I hope this helps. I dont have time to edit. I hope I was clear.

  3. darn. I should have edited. "interoception" is an evolving framing, if you will, of the need to consider why a child or adult is behaving in a counter productive way. Precisely addressing the need to identify a group of signs/symptoms that we know usually correlate with potentially impaired internal organ. We often know the why behind the what. There are often nonmedication and non surgical solutions that lead to comfortable and successful daily living. That is the point of our role with respect to addressing "internal organs". Indeed figure out what may provoke problematic organ function or inhibit necessary function. So, concurrently or following medical physician assessment (not to be replaced by doctor or PT or OT) we search for solutions that help optimize performance of that child or adults daily tasks with the least amount of interruption possible. There. I feel better. I thnk that should help you further understand. Keep asking if it doesnt. This isnt my blog, but I think I can speak for this practitioner, thanks for your great questions and concerns.