Introduction
Most people are familiar with the five traditional senses: sight, hearing, touch, taste and smell. However, there is another sensory system that plays a crucial role in everyday life yet is rarely discussed: interoception.
Interoception is often described as the body’s “hidden sense” because it helps us recognise and interpret signals coming from within our bodies. It is the reason you know when you are hungry, thirsty, tired, anxious, excited, unwell or need the toilet.
Over the past decade, researchers have become increasingly interested in the relationship between autism and interoception. Emerging evidence suggests that many autistic individuals experience differences in how they perceive and interpret internal body signals. These differences can affect emotional regulation, physical wellbeing, communication, mental health and everyday functioning.
Understanding interoception can provide valuable insight into many experiences commonly reported by autistic children and adults and can help parents, professionals and autistic individuals themselves better understand their needs.nces, improve communication and develop more effective support strategies.
What Is Interoception?
Interoception is often described as the body’s “hidden sense” because it helps us recognise and interpret signals coming from within our bodies. It is the reason you know when you are hungry, thirsty, tired, anxious, excited, unwell or need the toilet
Interoception is often described as the body’s “hidden sense” because it helps us recognise and interpret signals coming from within our bodies. It is the reason you know when you are hungry, thirsty, tired, anxious, excited, unwell or need the toilet
Interoception refers to our ability to recognise, interpret and respond to messages coming from within our body.
Interoceptive signals include:
- Hunger
- Thirst
- Fullness
- Fatigue
- Pain
- Temperature
- Heart rate
- Breathing rate
- Nausea
- The need to use the toilet
- Signs of stress and anxiety
- Physical sensations associated with emotions
Interoception helps us maintain physical wellbeing by allowing us to respond appropriately to these signals.
For example:
- Feeling thirsty prompts you to drink.
- Feeling cold prompts you to put on a coat.
- Feeling anxious may prompt you to seek support or remove yourself from a stressful situation.
When interoception functions differently, these signals may be missed, misinterpreted or noticed later than expected.
Interoception is often described as the body’s “hidden sense” because it helps us recognise and interpret signals coming from within our bodies. It is the reason you know when you are hungry, thirsty, tired, anxious, excited, unwell or need the toilet
What Is the Link Between Interoception and Autism?
Research suggests that interoceptive differences are common among autistic people, although experiences vary considerably from person to person.
Some autistic individuals may be:
Under-Responsive to Internal Signals
This may involve:
- Not noticing hunger until extremely hungry
- Forgetting to drink
- Not recognising fatigue
- Missing signs of illness
- Not noticing the need to use the toilet until the last moment
Over-Responsive to Internal Signals
Others may be highly aware of bodily sensations and find them overwhelming.
For example:
- Noticing every small physical discomfort
- Becoming highly aware of digestive sensations
- Finding changes in heart rate distressing
- Being particularly sensitive to pain or illness
Some autistic people experience both patterns in different situations.
Why Does Interoception Matter?
Interoception influences many areas of daily life.
Emotional Regulation
One of the most important functions of interoception is helping us recognise emotions.
Emotions create physical changes within the body.
For example:
Anxiety
May involve:
- Increased heart rate
- Muscle tension
- Butterflies in the stomach
- Faster breathing
Anger
May involve:
- Increased body temperature
- Muscle tightness
- Clenched fists
- Increased heart rate
Excitement
May involve:
- Increased energy
- Racing heart
- Feeling physically activated
Recognising these bodily sensations helps us identify emotions and respond appropriately.
If these signals are difficult to interpret, emotional regulation becomes much more challenging. Research suggests interoceptive differences may contribute to emotional dysregulation in autistic individuals.
Interoception and Alexithymia
Interoception is closely linked to alexithymia, which refers to difficulties identifying and describing emotions.
Research suggests alexithymia is significantly more common amongst autistic individuals than in the general population. One systematic review found that approximately half of autistic people experience alexithymia.
Difficulties interpreting internal body signals may contribute to difficulties recognising emotions.
For example:
An autistic person may notice:
- A racing heart
- Tension
- Stomach discomfort
but struggle to identify these sensations as anxiety.
As a result, they may know they feel uncomfortable but be unsure why.
Research exploring emotional difficulties in autism increasingly highlights the contribution of co-occurring alexithymia and interoceptive differences.
What Might Interoceptive Differences Look Like in Children?
Interoceptive differences can often be observed from an early age.
Parents may notice that their child:
- Rarely reports feeling hungry
- Forgets to drink
- Resists toilet use until the last minute
- Appears unaware of injuries
- Struggles to recognise when tired
- Becomes suddenly overwhelmed without obvious warning signs
- Has difficulty explaining physical discomfort
- Finds emotional questions difficult to answer
Some children may become distressed because they experience uncomfortable internal sensations but cannot identify what those sensations mean.
For example, they may become irritable when hungry without recognising hunger itself.
What Might Interoceptive Differences Look Like in Adults?
Autistic adults frequently describe experiences such as:
- Forgetting to eat or drink
- Working through illness without recognising symptoms
- Finding it difficult to identify emotions
- Struggling to know when to rest
- Experiencing burnout without noticing early warning signs
- Having difficulty recognising stress until overwhelm occurs
Many autistic adults report that they only realise they are exhausted once they reach a point of complete depletion.
Research exploring emotional dysregulation in autistic adults suggests differences in Interoception may contribute to delayed recognition of stress and emotional overload.
Interoception, Anxiety and Mental Health
Interoception may also play an important role in mental health.
If someone struggles to recognise internal signals, they may:
- Miss early signs of stress
- Fail to recognise increasing anxiety
- Struggle to identify emotional needs
- Have difficulty accessing appropriate coping strategies
Over time, this can contribute to:
- Anxiety
- Depression
- Burnout
- Emotional dysregulation
Recognising internal body signals earlier may help people take action before distress becomes overwhelming.
Interoception is often described as the body’s “hidden sense” because it helps us recognise and interpret signals coming from within our bodies. It is the reason you know when you are hungry, thirsty, tired, anxious, excited, unwell or need the toilet
Interoception and Autistic Burnout
Many autistic adults describe periods of significant physical, emotional and cognitive exhaustion known as autistic burnout.
Interoceptive differences may contribute because individuals may not recognise signs of:
- Fatigue
- Stress
- Sensory overload
- Emotional overwhelm
until they become severe.
This can make preventative self-care more difficult.
For example: Someone may continue socialising despite exhaustion because they do not fully recognise they need a break. Only later do they realise their resources have been depleted.
Can Interoceptive Awareness Be Improved?
Research suggests that many people can develop greater awareness of internal body signals over time.
The goal is not perfection but increased awareness.
Body Check-Ins
Regularly asking:
- Am I hungry?
- Am I thirsty?
- Am I tired?
- Do I need the toilet?
- Do I feel comfortable physically?
can help build awareness of internal states.
Linking Sensations and Emotions
It can be helpful to explore questions such as:
- What happens in my body when I feel anxious?
- Where do I notice stress?
- What physical signs tell me I need a break?
Over time, these patterns often become easier to recognise.
Using Visual Supports
Children may benefit from:
- Hunger scales
- Thirst charts
- Energy level check-ins
- Emotion thermometers
- Visual body maps
These can help make internal experiences more concrete and easier to understand.
Building Predictable Self-Care Routines
Because internal signals may not always be reliable, external routines can be helpful.
Examples include:
- Scheduled meals
- Regular hydration reminders
- Planned movement breaks
- Fixed bedtime routines
Many autistic adults find that relying solely on bodily cues can be difficult, whereas routines provide additional support.
Interoception Through a Neurodiversity-Affirming Lens
Interoceptive differences are not deficits that need to be eliminated.
Rather, they represent another way in which autistic people may experience and interpret the world differently.
Understanding these differences can help move away from assumptions that an autistic person is:
- Ignoring their needs
- Being difficult
- Overreacting
- Underreacting
and towards recognising that they may genuinely be receiving and interpreting internal signals differently.
Interoception is often described as the body’s “hidden sense” because it helps us recognise and interpret signals coming from within our bodies. It is the reason you know when you are hungry, thirsty, tired, anxious, excited, unwell or need the toilet
Key Takeaways
Interoception is the body’s internal sensory system that helps us recognise signals such as hunger, thirst, fatigue, pain, stress and emotions.
Research suggests interoceptive differences are common in autistic children and adults and may contribute to emotional regulation difficulties, alexithymia, anxiety, burnout and challenges recognising physical needs.
Understanding interoception can provide an important framework for explaining many experiences commonly reported by autistic individuals. By developing awareness of internal body signals and providing appropriate supports, autistic people can often gain greater insight into their physical and emotional needs and improve their overall wellbeing.
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Kinnaird, E., Stewart, C. and Tchanturia, K. (2019) ‘Investigating alexithymia in autism: A systematic review and meta-analysis’, European Psychiatry, 55, pp. 80-89. [pmc.ncbi.nlm.nih.gov], [cambridge.org]
Mahler, K. (2019) The Interoception Curriculum: A Step-by-Step Guide to Developing Mindful Self-Regulation. Shawnee Mission, KS: AAPC Publishing.
South, M. and Rodgers, J. (2017) ‘Sensory, emotional and cognitive contributions to anxiety in autism spectrum disorders’, Frontiers in Human Neuroscience, 11, p. 20.
Tchanturia, K. and Uljarević, M. (2021) ‘Alexithymia and autism spectrum disorder: Current evidence and future directions’, Current Opinion in Psychiatry, 34(2), pp. 80-86.
Trevisan, D.A., Bowering, M., Birmingham, E. and McPartland, J.C. (2021) ‘Interoception and autism spectrum disorder: A systematic review’, Neuroscience & Biobehavioral Reviews, 132, pp. 1042-1057.
