Sensory Spotlight: Interoception (Internal Bodily Awareness)

This is the ninth and final installment in our Sensory Spotlight series.

Interoception is the body’s ability to recognize and interpret its own internal cues, such as hunger, thirst, exhaustion, and pain. Children with interoceptive processing issues typically have disproportionately weak or strong reactions to normal bodily urges, such as feeling hungry or needing to use the bathroom. They may not be able to recognize pain or symptoms of exhaustion, or they might be unable to properly gauge the severity of such symptoms. You can read more about how the interoceptive system works on the STAR Institute’s website.

Like proprioception, interoception is not as commonly recognized as other senses, but it plays a critical role in the body’s ability to regulate and protect itself. It’s how you know when you’re exhausted and need to rest, when you’re hungry and need to eat, or when you’re cold and need to put on a jacket.

See below for a quick guide on identifying interoceptive seeking, avoiding, and discrimination issues in children.

Interoceptive Seekers May:

  • Have disproportionately weak reactions to normally bodily cues.
  • Crave interoceptive input and have problems with self-regulation.

Interoceptive Avoiders May:

  • Have disproportionately strong directions to normally bodily cues.
  • Constantly feel they are hungry, thirsty, or need to use the bathroom.
  • Feel pain more intensely or for a longer duration than others.

Those with Interoception Discrimination Disorder May:

  • Have disproportionately weak reactions—or no reaction—to normal bodily cues.
  • Have a high pain threshold and may not notice when injured.
  • Be unable to register hunger, thirst, or the need to use the bathroom until it’s an emergency.
  • Be unable to detect increased heart rate or breathing and may not feel tired until totally exhausted.

Sensory Spotlight: Proprioception (External Bodily Awareness)

This is the eight installment in our Sensory Spotlight series.

Proprioception, also known as kinesthesia, is the body’s ability to locate itself and its extremities in space using receptors in the skin, muscles, joints, and ligaments. It’s responsible for knowing how much effort to use when performing simple tasks, such as lifting a glass or using a pencil. Children with proprioceptive processing issues may have trouble gauging their own strength, or they may appear clumsy and frequently bump into walls, furniture, or other people. You can read more about how the proprioceptive system works on the STAR Institute’s website.

Proprioception isn’t as commonly known as sight or smell, but it’s a critical component of knowing how your body is positioned in relation to the world around you and how it should be moving. It’s how you’re able to walk up a flight of stairs while looking at your phone or find your way to the bathroom in a dark house.

See below for a quick guide on identifying proprioceptive seeking, avoiding, and discrimination issues in children.

Proprioceptive Seekers May:

  • Bump or crash into people or objects on purpose.
  • Enjoy rough play and constantly seem to be wrestling with siblings or friends.
  • Tend to stand too close to others or touch others without permission.
  • Crave bear hugs, holding hands, and other kinds of physical pressure.

Proprioceptive Avoiders May:

  • Avoid physical contact with others.
  • Appear very timid around peers and avoid physical play.
  • Refuse to play around slides, swings, and other playground equipment.
  • Become anxious in crowded spaces or when standing even somewhat close to others.
  • Be unable to properly assess risk in their physical environment. For example, they may believe they can fall into the small gap between the floor and an elevator.

Those with Proprioception Discrimination Disorder May:

  • Be unable to determine how much force they’re exerting on toys, pencils, etc.
  • Be unable to walk through familiar rooms in the dark without bumping into things.
  • Accidentally hurt themselves or others while playing.
  • Be unable to walk up or down stairs without watching their feet.

Sensory Spotlight: Gustatory (Taste)

This is the seventh installment in our Sensory Spotlight series.

The gustatory system is responsible for the body’s ability to detect the chemicals in food that allow us to differentiate between sweet, salty, sour, bitter, and umami (savory) sensations. While the act of tasting is technically limited to this chemical process, the gustatory and olfactory senses are closely linked and combine to create what we perceive as flavor. Children with gustatory processing issues may have an unusually high or low appetite or very particular food preparation requirements (served at room temperature, chopped into small pieces, etc.). You can read more about how the gustatory system works on the STAR Institute’s website.

See below for a quick guide on identifying gustatory seeking, avoiding, and discrimination issues in children.

Gustatory Seekers May:

  • Seem to have an unusually large appetite.
  • Chew or suck on inedible objects, such as clothing or toys.
  • Prefer foods with specific flavors, such as sweet, bitter, or spicy.
  • Prefer foods with specific textures, such as crunchy, chewy, or mushy.
  • Enjoy the taste or texture of non-food items, such as Play-Doh, glue, or paint.

Gustatory Avoiders May:

  • Seem to have an unusually low appetite and/or be underweight.
  • Be “picky eaters” and have very specific food preparation requirements.
  • Avoid foods with specific flavors, such as sweet, bitter, or spicy.
  • Avoid foods with specific textures, such as crunchy, chewy, or mushy.

Those with Gustatory Discrimination Disorder May:

  • Be unable to detect flavor or distinguish between flavors.
  • Seem to have an unusually low appetite and/or be underweight.

Note: Contact your pediatrician immediately if you think your child is either eating non-food items or refusing food for any reason other than sensory issues.

Sensory Spotlight: Olfactory (Smell)

This is the sixth installment in our Sensory Spotlight series.

The olfactory system is responsible for the body’s ability to detect and recognize smells using chemical receptors in the nasal cavity. Children with olfactory processing issues may have trouble identifying hazardous or poisonous substances, such as gasoline, or they may be able to detect very faint scents others can’t perceive. Because smell is one of the two senses associated with flavor, sensitive children may also be hyper aware of smells associated with food and cooking. You can read more about how the olfactory system works on the STAR Institute’s website.

See below for a quick guide on identifying olfactory seeking, avoiding, and discrimination issues in children.

Olfactory Seekers May:

  • Actively smell everything, even things with unpleasant odors.
  • Prefer meals or specific foods with new or very strong smells.

Olfactory Avoiders May:

  • Complain about smells that are very faint or unnoticed by others.
  • Hold their noses or gag when encountering strong smells.
  • Refuse to eat foods with strong, new, or specific smells.
  • Avoid using public restrooms or eating in public spaces.

Those with Olfactory Discrimination Disorder May:

  • Be unable to recognize familiar or very common smells.
  • Accidentally eat spoiled food or nonedible, potentially harmful substances.
  • Be unable to detect hazardous chemical or burning odors. However, they might be vaguely aware that something is wrong.

Sensory Spotlight: Vestibular (Balance and Spatial Orientation)

This is the fifth installment in our Sensory Spotlight series.

The vestibular system is responsible for the body’s sense of balance, motion, and spatial orientation. Children with vestibular processing issues may appear clumsy or hyperactive. They may also have issues tracking objects visually or performing fine motor tasks. 

The vestibular sense is a function of the inner ear and usually works in conjunction with sight. For instance, you’re able to ride in a car without feeling dizzy or nauseous because your vestibular and visual systems are sending matching signals to your brain; motion sickness occurs when these signals become mixed. The sensation of moving up or down in an elevator is an example of your vestibular system working in isolation. You can read more about how the vestibular system works on the STAR Institute’s website.

See below for a quick guide on identifying vestibular seeking, avoiding, and discrimination issues in children.

Vestibular Seekers May:

  • Appear to have hyperactivity or behavioral issues. 
  • Constantly be in motion—running, jumping, spinning, or climbing on furniture, etc.
  • Love being upside down and spinning in circles, but never seem to get dizzy.
  • Engage in fast, impulsive, or unintentionally rough movement while playing.
  • Have trouble concentrating while sitting or be unable to sit still for even short periods of time.

Vestibular Avoiders May:

  • Don’t lift, tilt, or move your child without giving a warning.
  • Hold your child’s hand while walking to provide grounding and support.
  • Use a footstool if your child’s feet can’t comfortably touch the ground while sitting.
  • Provide calm alternatives to playground activities, such as hiking or catch.
  • Teach your child to focus on a static point inside the vehicle to avoid motion sickness.
  • Work on calming strategies and develop a plan for how to exit overwhelming situations.
  • Provide a quiet place to lie down after motion sickness or headaches.

Those with Vestibular Discrimination Disorder May:

  • Appear clumsy or uncoordinated.
  • Have poor posture or jerky, awkward movements.
  • Have difficulty determining their head or body position.
  • Be unable to determine their speed and direction of movement.
  • Have difficulty distinguishing right vs. left and may not appear to have a dominant hand.
  • Be unable to tell when they’re starting to fall and unable to catch themselves in time.
  • Have poor spatial awareness and depth perception.

Sensory Spotlight: Tactile (Touch)

This is the fourth installment in our Sensory Spotlight series.

The tactile system is responsible for the body’s ability to perceive pressure, temperature, traction, and pain. Children with tactile processing issues may have an unusually high or low pain threshold and be very particular about the texture of their clothing, toys, and other surfaces. You can read more about how the tactile system works on the STAR Institute’s website.

See below for a quick guide on identifying tactile seeking, avoiding, and discrimination issues in children.

Tactile Seekers May:

  • Prefer toys, clothing, and food with varied or specific textures. 
  • Constantly touch or fiddle with clothing, surfaces, or other objects.
  • Crave hugs, kisses, and other frequent or prolonged contact with others.
  • Prefer messy play and activities, such as finger paint, play doh, and sand.
  • Tend to play too rough and accidentally harm others while playing.
  • Have difficulty recognizing and respecting others’ personal boundaries.
  • Have a higher than normal pain threshold and might not notice minor injuries.

Tactile Avoiders May:

  • Avoid toys, clothing, or food with specific textures.
  • Dislike being touched, hugged, or kissed, even by parents.
  • Avoid getting dirty and avoid playing in sand, dirt, or grass.
  • Dislike their hair or skin being wet and avoid swimming and bathing.
  • Refuse to wear tight, scratchy, or uncomfortable clothing with seams or tags.
  • Avoid play with other children and constantly worry about being touched or bumped.
  • Become anxious in crowded spaces or when standing even somewhat close to others.
  • Have a low pain threshold and respond to even light touch as if in pain.

Those with Tactile Discrimination Disorder May:

  • Not notice when they’re being touched.
  • Be unable to gauge the temperature of food and drinks.
  • Have difficulty identifying or distinguishing objects by feel.
  • Tend to play too rough and accidentally injure themselves or others.
  • Have difficulty recognizing and respecting others’ personal boundaries.
  • Have a high pain threshold and might not notice minor injuries.
  • Use too much pressure when writing or playing and frequently break pencils or toys.
  • Have difficulty performing certain motor tasks, such as getting dressed or riding a bike.

Sensory Spotlight: Visual (Sight)

This is the third installment in our Sensory Spotlight series.

The visual system is responsible for the body’s sense of sight. It allows us to perceive variations in the size, shape, color, and brightness of objects. It also helps us gauge the distance and speed of objects and determine where we should focus our attention. Children with visual processing issues may crave screen time or become overwhelmed in bright, busy environments. You can read more about how the visual system works on the STAR Institute’s website.

See below for a quick guide on identifying visual seeking, avoiding, and discrimination issues in children.

Visual Seekers May:

  • Seek bright or busy environments.
  • Prefer toys with bright, reflective, or shiny surfaces.
  • Be distracted by objects with spinning, flashing, or moving lights.
  • Insist on clothing and toys with specific shapes, colors, and patterns.
  • Crave screen time and prefer stimulating movies and games.

Visual Avoiders May:

  • Seek out dark or secluded environments.
  • Avoid messy rooms and busy, crowded spaces.
  • Frequently cover their eyes or hide their heads under pillows or clothing.
  • React strongly or as if in pain to bright, strobing, or fluorescent light.
  • Perceive dim, normal, or natural as much brighter than it actually is.
  • Be bothered or distracted by objects with bright, reflective, or shiny surfaces.
  • Be bothered or distracted by objects with spinning, flashing, or moving lights
  • Prefer clothing and toys with muted and simple shapes, colors, and patterns.

Those with Visual Discrimination Disorder May:

  • Have difficulty distinguishing between letters, numbers, and symbols.
  • Be slow to recognize characteristics of objects, such as size, shape, or color.
  • Be unable to judge the distance between people and other objects.
  • Have difficulty reading the facial expressions and emotional cues of others.

Sensory Spotlight: Auditory (Sound)

This is the second installment in our Sensory Spotlight series.

The auditory system is responsible for the body’s sense of hearing. It allows us to detect and locate sounds in our environment, to identify them, and to determine which sounds are important and which can be tuned out. Children with auditory processing issues may crave loud or repetitive noises, become overwhelmed or distracted by everyday sounds, or be unable to detect sounds in their environment. You can read more about how the auditory system works on the STAR Institute’s website.

See below for a quick guide on identifying auditory seeking, avoiding, and discrimination issues in children.

Auditory Seekers May:

  • Seek out loud or busy environments.
  • Seem to always be yelling or speaking too loudly.
  • Make repetitive sounds, such as clapping, tapping, or clicking.
  • Have difficulty focusing on a task without humming or making noise.
  • Prefer to have constant background noise, such as music, TV, or a fan.
  • Insist on listening to TV or music at a volume that is uncomfortable to others.

Auditory Avoiders May:

  • Seek out quiet or secluded environments.
  • Frequently cover their ears and react to loud or high-pitched noises as if in pain.
  • Become easily distracted by background noises others can’t detect.
  • Be bothered or extremely irritated by repetitive or specific sounds.
  • Be startled and extremely frightened by unexpected sounds.
  • Become overwhelmed and frustrated while working in loud, busy environments.
  • Engage in repetitive, self-soothing activities, such as rocking or chewing.

Those with Auditory Discrimination Disorder May:

  • Speak too loudly or too softly.
  • Appear unresponsive or confused when given verbal directions.
  • Take longer than usual to process and respond to verbal directions.
  • Be unable to distinguish between background and foreground noises.
  • Have difficulty distinguishing between similar sounding words (cat, rat, sat).

Sensory Spotlight: What Is SPD?

This is the first installment of our nine-part Sensory Spotlight series.

Sensory processing occurs when the brain receives and organizes information from external sources, such as light or sound, and internal bodily cues, such as hunger or balance. Individuals with Sensory Processing Disorder (SPD) do not respond to this everyday sensory information the same way most people do. They may feel bombarded or assaulted by even the smallest bit of stimulation, or they might be unable to recognize even very extreme sensations or changes in their environment. Studies suggest as many as 1 in 20 people have sensory processing issues, and symptoms are typically much more pronounced in children.

Children with SPD often have a hard time fitting in with their peer group. They might show signs of anxiety or depression, be withdrawn, struggle socially and academically, or appear clumsy. Many children have learned to cope with their symptoms in ways that might appear odd to others, such as rocking, constantly learning on walls or furniture, sucking on their thumbs or other objects, etc.

SPD is generally broken down into the three patterns and thirteen subtypes listed below. Keep in mind the exact symptoms will vary greatly from one individual to the next. Many people with SPD demonstrate a combination of sensitivities and seeking/avoiding behaviors, depending on their level of arousal and how familiar they are with their current environment.

Pattern 1: Sensory Modulation Disorder (SMD)

Sensory Over-Responsivity (Hypersensitivity) – Over-responsive individuals, or avoiders, are hyperaware of sensory input and may have extreme or upsetting reactions to even mild stimulation, such as crying out in pain while brushing their hair or gagging at very faint smells. Avoiders often feel overloaded and overwhelmed by everyday situations and may appear anxious, withdrawn, or defensive as a result.

Sensory Under-Responsivity (Hyposensitivity) – Those who are under-responsive have difficulties detecting and/or responding to sensory input in a timely manner. They might not notice that the lighting or temperature in the room has changed, for example, or that they’ve bumped into something and injured themselves. As a result, under-responsive individuals often appear distracted, dismissive, or clumsy.

Sensory Craving – Sensory cravers, or seekers, have a seemingly inexhaustible appetite for sensory stimulation, though they tend to become more keyed up and deregulated as they take in more input. Seekers usually demonstrate behaviors associated with Attention Deficit Hyperactivity Disorder (ADHD), such low impulse control and constant moving, fidgeting, bumping into things, or fiddling with objects.

Pattern 2: Sensory-Based Motor Disorder (SBMD)

Postural Disorder – Postural disorder affects the body’s ability to stabilize itself and maintain a sense of balance. Individuals with this subtype often have problems slouching or bad posture. They might also appear to be weak, move awkwardly, or have extremely low endurance.

Dyspraxia (Motor Planning Problems) – Those with dyspraxia have difficulty planning and performing new, nonhabitual gross and fine motor tasks. They might appear to have extremely poor hand-eye coordination, problems with concentration, and take much longer than their peers to learn a new skill.

Pattern 3: Sensory Discrimination Disorder (SDD)

Individuals with this pattern have difficulty recognizing and interpreting sensory information. They’re often unable to gauge the physical differences between objects, such as size, color, shape, or distance. They might be unaware of the pressure or force they’re exerting at a given moment and appear awkward, clumsy, and prone to spilling drinks or breaking toys.

SDD is further broken down into eight subtypes, one for each sensory system:

  • Auditory
  • Visual
  • Tactile
  • Vestibular
  • Olfactory
  • Gustatory
  • Proprioception
  • Interoception

We’ll be taking a deeper dive into each of these systems, including strategies for supporting children with SPD, as our Sensory Spotlight series continues. Stay tuned!

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