Interoception: The 8th Sense Explained, with Activities for Kids and Adults

Interoception is how we feel hunger, thirst, toilet needs and emotions inside the body. Signs of interoception difficulties and OT activities that help.

Sensory & Autism 10 min read

By

Published October 8, 2026

Child noticing body signals during an interoception activity

Have you ever met a child who doesn’t seem to notice they’re hungry until they’re furious, or who has toileting accidents long after their friends? Or an adult who only realises they’re stressed when they snap at someone? Often the missing piece is interoception.

What is interoception?

Interoception is the sense that lets us feel what’s going on inside our bodies. Special receptors in our organs, skin, muscles and bones send messages to the brain about:

  • hunger and fullness
  • thirst
  • needing to use the toilet
  • body temperature
  • pain and itch
  • heartbeat and breathing
  • muscle tension and relaxation
  • nausea and tiredness

The brain uses these signals to tell us what our body needs, so we eat, drink, rest, use the toilet or put on a jumper. Interoception is also a key part of emotions: a racing heart, a tight chest or “butterflies” are body signals we learn to read as feelings like fear, excitement or worry.

Interoception is one of eight sensory systems
Your8 senses Touch Tactile Movement Vestibular Body position Proprioception Inner body Interoception Sight Visual Hearing Auditory Taste Gustatory Smell Olfactory

Read more about the sensory systems, including vestibular and proprioceptive senses.

Interoception and emotions

Our emotions are built on body signals. Before we can say “I feel anxious”, we need to notice that our heart is fast and our stomach feels tight, and then make sense of that.

From body signal to self-regulation

  1. Notice

    "My heart is beating fast and my hands are sweaty."

  2. Connect

    "That usually means I'm nervous."

  3. Act

    "I'll take some slow breaths and ask for help."

If the first step is hard, if a person doesn’t notice the body signals, the next steps are hard too. That’s why interoception difficulties can look like sudden meltdowns, “from 0 to 100” reactions, or trouble calming down.

Signs of interoception difficulties

People can experience interoception differently. Some notice body signals less (under-responsive), some notice them more intensely (over-responsive), and some find signals unclear or hard to tell apart.

Area Signs in childrenSigns in teens and adults
Toileting Frequent accidents after the usual age; rushing to the toilet at the last minuteNot noticing bladder signals until urgent
Eating and drinking Doesn't notice hunger, or seems hungry all the time; doesn't feel fullForgets to eat; overeats; doesn't feel thirst
Temperature Wears a coat in summer or shorts in snowDoesn't notice being too hot or cold
Pain Doesn't notice injuries, or is very upset by small bumpsHigh or very low pain sensitivity
Emotions Meltdowns that seem to come from nowhere; can't say how they feelDifficulty naming feelings; notices stress only when overwhelmed
Sleep and energy Doesn't seem to feel tiredPushes through exhaustion

Interoception differences are common in autistic people and are also described in ADHD, anxiety, PTSD, eating disorders and sensory processing differences.

How occupational therapists help

Occupational therapists help people notice, understand and respond to body signals so daily life feels more manageable. A widely used approach is The Interoception Curriculum by occupational therapist Kelly Mahler, a step-by-step framework that builds body awareness before linking it to emotions. Early studies of interoception-based programs in classrooms and with autistic children have reported improvements in emotion regulation, though the research is still growing.

Building interoception step by step

Goal ↑

  1. Use strategies

    Choose a calming or alerting strategy that fits the feeling.

  2. Link to emotions

    "When my heart races and my hands shake, I'm nervous."

  3. Notice body signals in daily life

    Hunger, thirst, temperature, toilet signals.

  4. Notice changes in one body part

    Hands feel cold, then warm; muscles tense, then relaxed.

  5. Feel it, name it

    Simple, playful experiences with clear body sensations.

Start here

Interoception activities to try

Make these playful, short and regular. The aim is to notice and describe, not to get the “right” answer.

Activity What to notice
Jump, then freeze Do 20 star jumps, then put a hand on your chest. Is your heart fast or slow? Is your breathing quick or calm?
Warm and cold hands Hold a cold drink, then a warm cup. How do your hands feel? Which do you prefer?
Squeeze and let go Squeeze your hands into fists for 5 seconds, then let go. What's the difference between tight and floppy?
Blow it out Blow bubbles slowly, then quickly. What happens to your breathing and your tummy?
Taste test Try sour, sweet and minty foods. What happens in your mouth?
Body check-in Three times a day, ask: Am I hungry? Thirsty? Need the toilet? Hot or cold? Tired?
Feelings body map Draw a body outline and colour where you feel worry, excitement or anger.
More interoception activities
Activity What to notice
Breathing buddy Lie down with a soft toy on the tummy and watch it rise and fall.
Spicy, sour, minty Notice how different tastes feel in the mouth and nose.
Run, then rest After a run, notice sweat, heartbeat and breathing as the body calms.
Yoga poses Notice which muscles stretch or work in each pose.
Ice pack and warm bean bag Compare cold and warm on the arm or neck.
Hum and buzz Hum and feel the vibration in the throat, chest and lips.
Feelings detective When a feeling shows up, find where it lives in the body.

Interoception activities for toileting

Toileting accidents are one of the most common reasons families notice interoception differences. Alongside medical checks, these strategies help:

  • Scheduled toilet times (for example, on waking, after meals and before leaving the house) while body awareness develops
  • Notice the “full” feeling: after drinking a big glass of water, check in every 10–15 minutes: “What do you notice in your tummy?”
  • Name the signal when it happens: “Your tummy feels tight and you’re wiggling. That might be your bladder telling you it’s full.”
  • Visual body chart in the bathroom showing where bladder and bowel signals are felt
  • Praise noticing, not just success on the toilet

Summary

Interoception is the sense of the body’s inner signals. It underpins basic needs like eating, drinking and toileting, and it’s the foundation for recognising and managing emotions. When interoception works differently, daily life can feel confusing and overwhelming. Occupational therapists help people tune into their bodies step by step, using playful, practical activities. Read more about sensory integration and building a sensory diet.

Related guides: Heavy work activities, OT goals for autism, Self-regulation activities.

References

  • Mahler K. Interoception: The Eighth Sensory System. AAPC Publishing; 2016.
  • Mahler K. The Interoception Curriculum: A Step-by-Step Framework for Developing Mindful Self-Regulation. 2019.
  • Mahler K, et al. An interoception-based intervention for improving emotional regulation in children in a special education classroom: feasibility study. Occupational Therapy in Health Care. 2024.
  • Craig AD. How do you feel? Interoception: the sense of the physiological condition of the body. Nature Reviews Neuroscience. 2002;3(8):655–666.
  • Khalsa SS, Adolphs R, Cameron OG, et al. Interoception and mental health: a roadmap. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging. 2018;3(6):501–513.

Frequently asked questions

What is interoception?
Interoception is the sense that lets us feel internal body signals, such as hunger, thirst, a full bladder, body temperature, pain, heart rate, breathing and muscle tension. The brain uses these signals to tell us what our body needs and to help us recognise emotions.
Why is interoception called the 8th sense?
We usually learn about five senses: sight, hearing, touch, taste and smell. Occupational therapists also include the vestibular sense (movement and balance) and proprioception (body position). Interoception, the sense of the body's internal state, is often counted as the eighth.
What are signs of poor interoception in children?
Common signs include frequent toileting accidents after the usual age, not noticing hunger or fullness, not dressing for the weather, not noticing injuries or being very upset by small ones, and emotional outbursts without warning because the child doesn't notice feelings building.
How is interoception linked to autism?
Research suggests many autistic people experience interoception differently. They may notice body signals less, more intensely or in ways that are hard to interpret. This can affect toileting, eating, sleep and emotional regulation.
How can I improve interoception?
Through regular, playful body check-ins: noticing how the heart, breathing and muscles feel before and after activities, exploring warm and cold, tense and relaxed, and linking body feelings to emotion words. An occupational therapist can create a step-by-step program, such as one based on Kelly Mahler's Interoception Curriculum.

Written by

Deepam Pawar is an occupational therapist and co-founder of Occupational Therapy OT. He focuses on clinical frameworks, assessment, and evidence-based practice.

All articles by Deepam →

This article is for general education and is not a substitute for individualized assessment or treatment by a licensed occupational therapist. Always seek the guidance of a qualified professional for specific concerns.

More in Sensory & Autism