Interoception: Helping Children Develop their “Hidden Sense”

By August 5, 2020NESCA Notes 2020

By: Sophie Bellenis, OTD, OTR/L

Occupational Therapist; Real-life Skills Program Manager and Coach

In our last OT Tuesday, we reviewed the sense of interoception, the ability to perceive information coming from inside the body. From basic human experiences, such as hunger and fatigue, to more complex internal emotions, such as anxiety and fear, interoception allows us to perceive and understand the sensations coming from our own bodies. As with other senses, this sense develops as children grow and, like the rest of us, will all have varied abilities. Some of our kids are naturally in tune with their bodies – they take to potty training without a hitch, recognize when they need a snack or a drink of water, and intuitively understand what their bodies are trying to tell them. Unsurprising, these exceptionally well regulated kids are not the majority, and most of our children benefit from some guidance, modelling and direct education on how to interpret the signals and sensations they are experiencing. Let’s discuss some tips and strategies for helping children to perceive, understand and appropriately respond to this internal information. Many of these tips are simple ideas to build into daily life and ways to take advantage of naturally occurring teachable moments.

Language – Incorporating language that teaches children to acknowledge internal cues and body sensations helps them to naturally and consistently notice the clues they are receiving from their bodies.

  • Verbally describe the choices that you make based on your own sense of interoception.
    • “I am going to put on a jacket because when I stepped outside this morning, I felt really cold.”
    • “My mouth feels dry and I’m starting to get a bit of a headache, I am going to have some water because my body is telling me that I am thirsty.”
  • Link requests that your child makes to how they may be feeling inside.
    • “You asked me for a snack. Are you hungry? How is your belly telling you that you’re hungry?”
  • Point out physical clues that hint at internal sensations.
    • “I notice you are having a hard time keeping your eyes open. That tells me you are feeling tired.”
    • “You are crossing your legs and dancing around a bit while you are coloring that picture. I think that your body is giving signals that you have to pee. It is important to pay attention to those signals so that you don’t wet your pants.”


  • Check Your Pulse! – Have your child sit quietly and teach them how to feel their pulse or heartbeat. Ask them to describe it – is it slow, fast, moving, hitting their fingers, etc.? Then have them run in place and do the same thing. How has it changed? Have them describe it now. Once children understand how their heartrate may be affected by physical activity, a next step would be pointing out that strong emotions, such as anger or excitement, can also affect one’s heartrate. This is a simple activity that provides some biofeedback and teaches children how their actions can affect their bodies.
  • Mindfulness – Zen Master, Thich Nhat Hanh defines mindfulness by stating, “Mindfulness shows us what is happening in our bodies, our emotions, our minds, and in the world.” While not all mindfulness activities focus on interoception, many of the principles and activities build this skill. If you are looking for some resources to work on mindfulness with your child, explore these sites: org,,, and Additionally, consider some apps to use with your child: Mindful Powers, Smiling Mind, Breathe Think Do with Sesame and Headspace.
  • Breathing exercises – Breathing exercises are common in mindfulness and can help children to relax. If apps are not for you, consider researching breathing exercises, such as: five-finger breathing, lazy 8 breathing or bumblebee breathing.
  • Progressive muscle relaxation – This practice involves alternating tension and relaxation in different muscle groups in the body. Dr. Monica Fitzgerald provides an excellent script to use with children working to relax here. If you are interested in exploring this practice with children with disabilities, many resources can be found at org.
  • Yoga – Yoga focuses on intentionally moving the body, pairing body movement and breathing, and increasing the mind-body connection. There are many apps and online videos that make yoga accessible to children. Some options include Simply Yoga, and Cosmic Kids Yoga. For some of our children who may need yoga broken down and presented differently, consider com or


About the Author

Dr. Sophie Bellenis is a Licensed Occupational Therapist in Massachusetts, specializing in educational OT and functional life skills development. Dr. Bellenis joined NESCA in the fall of 2017 to offer community-based skills coaching services as a part of the Real-life Skills Program within NESCA’s Transition Services team. Dr. Bellenis graduated from the MGH Institute of Health Professions with a Doctorate in Occupational Therapy, with a focus on pediatrics and international program evaluation. She is a member of the American Occupational Therapy Association, as well as the World Federation of Occupational Therapists. Having spent years delivering direct services at the elementary, middle school and high school levels, Dr. Bellenis has extensive background with school-based occupational therapy services.  She believes that individual sensory needs and visual skills must be taken into account to create comprehensive educational programming.

To book an appointment or to learn more about NESCA’s Occupational Therapy Services, please fill out our online Intake Form, email or call 617-658-9800.


Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email or call 617-658-9800.