Interoceptive Awareness in Autism and ADHD

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Interoception is the ability to identify, understand and respond to the state of the inside of our body. This is something that many autistic people and those with ADHD struggle with.

Interoceptive awareness allows us to feel things like hunger, thirst, whether we are hot or cold, if we need the bathroom and if we are in pain, amongst other things.

Most people can tell when they are hungry. They might feel their stomach growl, and they will start thinking of food and what they will eat and when. In the meantime, they might get a bit grumpy or struggle to concentrate. The same goes for knowing when you need to use the bathroom. Most people would feel an urge to pee and would start thinking about finding the bathroom. And if someone felt hot, they would recognise their body heating up and know to take their jumper off.

Now, imagine if you were unable to tell that you were hungry or that you were full. If you couldn’t feel that you were overheating. If you really needed the toilet, but couldn’t tell that you needed it. If you were in pain but couldn’t know this. Rather than acting on these signals and relieving the problem, you might become irritable, easily frustrated, have difficulty concentrating or sitting still and struggle to regulate your emotions. This could result in emotional outbursts, meltdowns or arguments.

Poor interoceptive awareness can lead to poor emotional regulation and self-regulation, because not recognising these essential bodily cues and signals mean your basic needs are not met, so everything is out of balance. This can cause serious problems. For example, not knowing that you need to use the bathroom means you won’t go, which can cause UTI’s, constipation or humiliation. If you are in pain, but can’t tell, the root cause of the pain could be made worse, for example by continuing to put strain on a damaged part of your body. It could also meant hat the root cause of the pain is left untreated, since it isn’t investigated.

Interoceptive difficulties are not only found in autistic people, but it is commonly associated with autism, as well as ADHD. These difficulties can be more present in autistic/ADHD children, since it can take time for them to learn to recognise these cues.

There are things which can help us to develop better interoceptive awareness. There are bodily awareness activities which can help us to understand how different parts of our bodies are connected. We can learn to associate different feelings with particular needs. For example, a list of signs that we may notice when we are hot can help us to decipher when we are hot and if we need to take our jumper off. Recognising these cues isn’t inherent to some of us, so we have to learn to recognise them, if we are able to. Something that helps me is setting alarms reminding myself that I need to drink or eat something. Even alarms reminding you to go to the loo can be helpful.

It’s important to note that difficulties with interoception are not always the same every day. For example, being preoccupied with tasks, strong emotions or feeling overwhelmed, having high anxiety levels or experiencing changes in routine can affect our interoceptive awareness.

Sources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5985305/
https://pubmed.ncbi.nlm.nih.gov/30937850/
https://www.kelly-mahler.com/what-is-interoception/

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