What Is Interoception?
Interoception, otherwise known as the eighth sense, is the awareness of how we feel internally. Interoception enables us to process the internal physical sensations we experience and the feelings that go along with them. For example, our stomachs may growl when we have not eaten in a while and feel “hangry”; if we are tired and yawn and we may feel overwhelmed by the tasks we still need to complete.
Interoception, Toileting, and Autism
Interoceptive awareness impacts many aspects of our daily lives. Many people with autism or other sensory processing disorders struggle with interoception. Their bodies’ signals are unclear, leading to difficulty identifying how they feel. This might be because sensations are so intense that it is overwhelming to pick out any single emotion, or it could be the opposite. If sensations are very dull then people may not notice until it is too late.
Toileting regulation becomes a common problem for kids with autism and lower interoceptive awareness. Sometimes they constantly feel as though they need to go to the bathroom, even if they just went a few minutes ago. Other times they don’t notice their body signaling the need to eliminate until it is too late and they’ve wet themselves or gotten constipated. This frequently leads to low self-esteem, especially as kids get older.
How to Improve Toileting Through Interoception
There are several strategies that parents can use to help their children develop better interoception and reduce the number of accidents or bouts of constipation. The first step is to educate yourself. Read up on interoception and the ways it impacts children with similar struggles. Observe your child’s behavior and try to identify patterns that may give you insight into their experience. Once you’ve learned more, try some of these ideas:
1. Model interoceptive awareness.
Start to verbally describe how you feel and the physical sensations that alerted you to the feeling. Have to go to the bathroom? Tell your child what it feels like; perhaps your stomach gets tighter or you feel an urge to push. Thirsty? Describe the sensation of a scratchy, dry mouth that alerted you to drink water.
2. Ask your child how they feel.
Create a dialogue with your child about their feelings and the sensations behind them. If they haven’t eaten in a while, ask them if they feel hungry. Maybe they just used the bathroom but say they need to again; encourage them to describe the physical sensations that told them they need to go to the bathroom. There are no right or wrong answers. The goal is simply to help your children make the connection between their sensations and feelings.
3. Adapt to your child’s needs.
Different strategies work for different people, so identify which tools are most effective for your child. Create a visual schedule of their day to show them exactly when to take a bathroom break. You can set alarms periodically or establish rules for your child to follow, such as going to the bathroom an hour after meals. Reading social stories about toileting can also help children become more comfortable with using the bathroom and learn to do so at regular intervals.
While these external tools can be extremely helpful, it’s important to keep in mind that these are a stepping stone in the overall process. You want to help your child develop a self-directed awareness of their internal feelings for cues of when to use the bathroom. If you start with a schedule or alarms, take a moment after each bathroom break to allow your child to describe any sensations they felt.
4. Play the emotion identification game.
Take the stress out of interoceptive awareness by turning it into a game with your kids. Everyone gets a turn to describe the sensations that go with a certain emotion. One emotion that might go with toileting is a sense of urgency. Again, there are no right or wrong answers here. The aim is to get your child to talk about and form connections between certain sensations and feelings, like the need to eliminate.
By taking interoception out of the context of actually knowing when to do certain things, it removes the stress for your child and may help them improve their awareness.
Don’t Be Afraid to Ask for Help
Even the best parents need support. Working with an occupational therapist can help further teach your child to notice sensations and assign appropriate meanings to them. By consistently using the strategies listed above and working together with an OT, you are providing your child with the tools they need to self-regulate their toileting habits and feel empowered in their daily life.
Which strategies helped your child develop greater interoceptive awareness? Do you have any toileting tips for other parents? Share them in the comments or send us an email at email@example.com.