This is a sensory system that is relatively unheard of. The system is taken for granted by most adults and often ignored when life gets too busy. The interoceptive system comprises of information or signals gathered from inside the body. This system enables our brains to know when we feel hungry, thirsty, tired and when we need the toilet etc.
Just like the other systems which we have discussed in the past, this system can also be over and under responsive. But what does this mean for little children?
As adults we often get irritable if we have not eaten or if we feel over tired, but generally we know why we have not been feeling like ourselves during a difficult day. We can sit back and remember that we have not eaten yet or that we have not been sleeping well for a couple of nights and then adapt our behavior accordingly. We feel when we need to use the bathroom and therefore we do not have humiliating accidents.
Now imagine if your body sent up these signals to your brain, but it was not “heard”… like knocking on a pillow. We might then find ourselves starving at the end of a day or dehydrated due to too little fluid intake or close too burnout because of too little sleep.
This system just like the other systems, needs to develop appropriately and then children learn to control their bladders and bowls, ask for food or drink and verbalizes when they feel tired. This system can also take longer to develop or the messages that it sends to the brain might be like knocking on a pillow and then we see a child who is unaware of their physiological needs. These children often struggle to be potty trained and might still have accidents up until late in their primary school years.
Your children can also be defensive, under-responsive or seeking in this system. Let us look at the difference here.
For the little ones who have a low threshold for interoceptive input they get from their bodies might be very overwhelming. They can interpret a pounding heart as we as adults would a panic attack. These children can either be seen using the bathroom more frequently than expected as the sensation of having a fuller bladder or bowl is painful or they may not use the bathroom as often as they need to because the process is interpreted by the brain as too painful. This then leads to constipation and bladder infections. It can be very distressing for s child too feel this way and the behavioural component would have a big influence on the child’s functioning. It is speculated that a child with a sensitivity/ defensiveness for the information from the interoceptive system, might experience hunger pains very intensely and this may cause the child to over eat as they try to avoid the feeling of hunger at all cost.
These little ones enjoy the sensation of a pounding heart or being out of breath. They might be on the move all the time in order to achieve this. They may also have trouble with bladder and bowel control as they may enjoy the sensation of having to go, but not going. This can then also lead to constipation and bladder infections.
For little ones who have difficulty discriminating the information they receive from their bodies, life can be a very confusing matter. They may not realize how urgent the need for the toilet is until it is too late. They may not know that they are behaving in a certain manner due to them being hungry or thirsty and therefore they struggle to rectify the matter and the behavior escalates.
So how do we as OT’s fix this?
Just the same way we work on any of the other systems. We help the child understand their bodies and work on self-awareness and regulation. The proprioceptive and vestibular system is believed to be linked closely to the interoceptive system and by targeting these more obvious systems, I have had success treating children who struggle with bowl and bladder control.
I hope that this article helps you understand your child a bit better. Please do not think that your child is “just naugthty” or “on purpose” when accidents happen. Rather investigate the need for some intervention.