Pediatric Occupational & Physical Therapy | Sensory Pathways 4 Kids

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The 8th Sense: Interoception

We grow up learning the 5 senses; Touch/Tactile, Hearing/Auditory, Smell/Olfactory, Taste, Sight. Then learning that there are 2 more; Vestibular(inner ear moving through space/balance) and Proprioception (input into muscles and joints). But there has been more research on an additional 8th sense; Interoception.

Interoception is defined by the sense of knowing/feeling what is going inside your body including internal organs and skin (i.e hunger, thirst, pain, arousal, bowel and bladder, body temperature, itch, heart rate, nausea, and feelings such as embarrassment and excitement etc.). These types of internal feelings can trigger negative reactions, as children have a hard time depicting between what these feelings are and what they need to get back to optimal “green zone” level. To others, it looks like behavior but really it is the only way they care able to communicate how they are feeling.

For example, you pick your child up from school and you are so excited to ask them how their day was but once they get into the car, they are screaming/yelling, crying and throwing their backpack at you etc. You keep telling them to calm down but they are inconsolable. The 5 min car ride seemed like 30 and then you try to understand what had happened. You get inside and send them to their room for how they reacted and look in their backpack to an uneaten lunch and then put everything together; they are hungry. (Snickers commercials are a great example of this! :) )


Children who have difficulties with this sense encounter either overresponsive or underresponsive reactions:

If a child is OVER responsive, extremely sensitive to stimulus, they are experiencing even the slightest feeling of these internal senses. They may be very distracted/anxious with a small feeling of hunger/thirst or with bowel/bladder resulting in not getting to the bathroom in time and having an accident. You can see an overreaction to pain when getting bumped/scratched or tripping or once they get home they are taking clothes off, as well as emotions being “felt” in our body (heart beating fast, shallow/fast breathing, getting hot or having stomach pain with not wanting to go to school etc.) and getting upset but not sure why.

If a child is experiencing UNDER responsive tendencies to Interoception, requiring a large amount of input to be received by the brain, you would see frequent bed wetting at night, constipation or difficulty with recognizing if they had an accident; especially during potty training (no knowledge of wet/soiled clothes/diaper), not hungry till they are starving, fall frequently and unable to tell that they have a huge scrape/bleeding and not wearing the right clothing or an excess of clothing for the appropriate weather. You may not see emotions with under responsive children ,“flat affect” or no reaction with certain stimulus.


Regulation is a huge factor in helping kiddos understand what is going on internally and then make a connection to verbally express how they are feeling or be independent in solving the problem on their own. Starting with a healthy diet, appropriate amount of sleep for their age and movement!

If you have any questions, consult a Sensory Pathways 4 Kids Occupational Therapist to start an appropriate Home Exercise Program and plan for you and your family.

-SP4K