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Interoception

Information and resources to support education and care services in the practical application of interoception.

What is interoception?

Interoception is a pre‐requisite skill for self‐management and self‐regulation. It provides the tools to know when we are developing emotional reactions and the skills to be in control of those reactions.

Interoception is an internal sensory system in which the internal physical and emotional states of the body are noticed, recognised, identified and responded to. 

Interoception skills are required for a range of basic and more advanced functions such as knowing when to go to the toilet, being aware that you are becoming angry or upset and being able to manage your emotions proactively. 

When children and young people have not yet developed interoception skills they will struggle with not only their own emotions but with social interactions and even just being around others may be difficult for them to manage.

Children and young people with well-developed interoception are able to use both logic and emotions to respond to their environment, whereas those without tend to rely on logic and have to carefully think through their possible responses to each situation. 

Thinking through each situation long term can be extremely tiring and can contribute to overload, shutdown, meltdowns, anxiety and depression.

Benefits of teaching interoception

  • To help children/students connect to and learn to understand their own bodies and emotions.
  • Without interoception, social skills are just the application of rules and not a meaningful way of interacting – it enables students to develop a sense of belonging.
  • Classrooms where interoception is being taught have decreasing behavioural challenges over the school year and those where it is not have static or increasing behavioural challenges (school wide behaviour reporting analysis).

Models of interoception in education and care settings

In class teaching:

  • for individual classes
  • across the whole site
  • across the whole site with specific groups of intensive interoception
  • across the whole site plus the use of an interoception room.

Models of interoception for in class teaching

Incorporating interoception into the class does not require any additional resourcing as it is implemented as part of quality differentiated teaching practice. 

  • Two to three short sessions a day, each session covering one or two interoception activities. Activities are done twice. After the first time students are asked where they felt the difference or what they felt. They are then guided where/what to feel and asked to focus on that for the second time the activity is done. Sessions are most beneficial after breaks, so 2/3 of first thing in the morning, after recess, after lunch. 
  • Multiple short sessions a day, each session covering one or two interoception activities. Activities are done twice. After the first time students are asked where they felt the difference or what they felt. They are then guided where/what to feel and asked to focus on that for the second time the activity is done. Sessions are after every transition and/or whenever the students require refocusing.
  • One or two long sessions a day, each session lasting 15-20 minutes. Usually chosen for use in specific classrooms where children/students arrive dysregulated and struggle all day. Interoception activities are presented as a sequence of movements and actions with directions to focus on specific muscles or other aspects of interoceptive awareness. 

What is an interoception activity?

An interoceptive activity focuses on creating and noticing a change in some aspect of one’s internal self, such as muscular system, breathing, temperature, pulse or touch. People with atypical interoception are not able to identify the physiological changes that signal mood changes or bodily self‐regulation needs. Interoception activities teach us to connect with these. 

Structure of an interoception activity

An interoception activity focuses on a particular part of the body for at least 30 seconds.

  • It enables a change to occur in one’s body state while labelling the movement and part of the body involved (e.g. toes, stretch and curl up or curl under)
  • Repeat the same activity for a second time
  • The individual is encouraged to identify a change in their body state (e.g. hot‐cold, soft‐hard, stretch‐relax).

Interoception tools

An interoception support plan HSP421 (DOC 170KB) may be completed by the education or care service, family and the child or young person (where possible). This will provide a detailed understanding of the interoception issues and support the development of individualised strategies to increase interoception.

The interoception 101 activity guide (PDF 2582KB) will provide an in-depth theory of interoception and beginning exercises for the practical application of interoception.

The interoception 201 activity guide (PDF 3299KB) can be used when you have exhausted the beginning activities in interoception 101 and are looking for new activities and further embedding interoception into class activities.

The interoception guide (PDF 610KB) is a summary of interoception, activities and benefits.

An interoception activity plan HSP422 (PDF 74KB) can be used as a template by education staff to plan for the inclusion of interoception activities into daily class activities.

An interoception personal best tracking sheet HSP423 (PDF 116 KB) can be used by children and young people to record their person bests for interoception activities.

The engagement observation record HSP424 (Word 123KB) is used to collect data on the level of engagement in learning of children and young people through a short observation. Tracking levels of engagement is a useful tool to monitor the effectiveness of strategies. 

The interoception room record HSP425 (Word 114KB) can be used to collect relevant information needed to evaluate when children and young people are requiring the additional support needed by the interoception room and if there are additional contexts and professional development requirements for staff. 

The strengths and difficulties questionnaire HSP426 (SDQ) (Excel 159KB) is a brief emotional and behavioural screening questionnaire for children and young people. The tool can capture the perspective of children and young people and their teachers.

The 25 items in the SDQ comprise 5 scales of 5 items each. The scales include:

  • Emotional symptoms subscale
  • Conduct problems subscale
  • Hyperactivity/inattention subscale
  • Peer relationships problem subscale
  • Prosocial behaviour subscale

The SDQ can be used for various purposes, including clinical assessment, evaluation of outcomes, research and screening. 

Interoception in the Australian Curriculum (PDF 150KB) provides detailed information for education staff on how interoception can be incorporated into the curriculum to support children and young people’s learning.

Other neurodiversity resources to support interoception

Sensory

Many children and young people live with sensory processing differences (SPD) making it difficult to process and act on information received from the senses. Most children with SPD display elements of extremes where they suffer from sensory overload sometimes and seek stimulation at other times.

It is important to understand their sensory needs and implement strategies to enable a positive experience in the education or care setting.

A sensory overview support plan HSP431 (DOC 389KB) may be developed by the education or care service, family and the child or young person (where possible). This will provide a detailed understanding of the sensory issues and support the development of strategies to minimise sensory seeking or avoidance.

Regulation scale

The regulation scale HSP432 (DOC 182KB) is a tool that can be used for any child or young person to identify what is happening around them that is impacting on their mood change, what signals their body is giving them, and ways to respond to their body’s signals that will help them manage the change in mood.

The child or young person should be involved as much as possible in developing the scale, with input from parents and staff to support them.

The scale can evolve and change over time as the child develops better interoceptive awareness and expands their vocabulary (non-verbal/verbal). This scale is designed to be used in conjunction with interoception activities so the child is working towards meaningful development of interoception skills.

Interoception is the foundation for developing emotional regulation skills and some children will require explicit teaching to develop these. Some children (especially those who have experienced trauma and/or neglect) struggle to manage mood changes which may be associated with a minor increase in stress levels (new learning, trying something different). For these children, minor stress may induce uncomfortable feelings which trigger a ‘flight, fight, freeze’ response. These children require support to differentiate between feeling slightly challenged/minor discomfort and feeling unsafe/in danger so they can respond differently.

Some examples of completed regulation scales include:

Understanding Behaviour

Traditional behaviour management focuses on what to do after behaviour has occurred, but does not determine the purpose of the behaviour.

The behaviour can often be prevented by making modifications to the environment, people, places, time or activities and teaching the child or young person a more appropriate way to get their message across.

It is important to determine the reason for the behaviour before we can try to prevent the occurrence. This may include:

  • identifying dangerous, damaging and disruptive behaviours; and which behaviours are just annoying or irritating to others
  • investigating what triggers the behaviour, when and where the behaviour is most likely and least likely to occur
  • looking at what happens after the behaviour.

By using this information we can identify the purpose of the behaviour and teach appropriate alternative behaviours and new skills.

The understanding behaviour template HSP 433 (PDF 456KB) is a useful tool to assist in determining the reason a behaviour is occurring and to plan and implement a replacement behaviour. This worksheet is used for a single behaviour and works most effectively when education staff, families and the child or young person work together to develop.

The template includes a most likely/least likely table that can be used to identify possible triggers for the behaviour of concern. Documenting what is happening when the behaviour is most likely to occur (place, people, time and activity) and comparing it to times when the behaviour is least likely to occur. It is equally as important to identify when the behaviour doesn't happen. This form is used to gather additional information that can provide useful clues in identifying the purpose of the behaviour. The information concerning least likely times for the behaviour also signals possibilities for the ideal teaching environment best suited to that young person.

Professional development and training

The Disability and Complex Needs team provide an in-depth education on interoception and practical strategies to enable the integration of interoception activities in classroom activities and to support the development of individualised strategies for children and young people with low levels of interoception.

Senior advisors are able to visit your site to deliver professional development and provide ongoing support.

Refer to the Health Support Training webpage for further information and contact details. 

Resources

Care plans

Support plans

Planning and management tools

Research

Contact

Disability and complex needs team

Phone: 8226 3620
Email: education.health [at] sa.gov.au