Many parents and school staff are familiar with this situation: The child doesn’t drink anything all morning, doesn’t go to the bathroom until it’s almost too late, and barely notices any of it. This is often interpreted as absent-mindedness or defiance, which isn’t true. There’s a reason behind it that people rarely talk about: interoception—the perception of one’s own bodily signals.
What exactly is interoception?
In addition to the familiar senses, there is another one that is directed inward. It signals whether you’re hungry or thirsty, whether your bladder is full, or whether your energy is slowly waning. For many people with autism, the neural network that processes these internal signals (primarily the insular cortex) functions differently, and this is clearly evident in everyday life. The signals arrive more faintly or with a delay—sometimes only when the body has long since reached a critical state. At that moment, a child does not feel a clear “I’m hungry.” They only notice vaguely that something is wrong, without being able to say what it is.
How does this affect everyday life?
Much more often than you might think. There’s the child who goes hours without drinking anything and sits there in the afternoon with a headache and a loss of concentration, or the teenager who passes out and only finds out afterward that he hasn’t eaten anything since breakfast. Pain and exhaustion are also part of the picture; an injury goes unnoticed until it’s too late, and overexertion is often only recognized after it has long since culminated in a meltdown. Anyone who interprets this merely as defiance is reacting to the wrong thing and overlooking the fact that the child simply lacks the necessary information.
What helps?
You can hardly “train” your sense of well-being itself—that would be an unrealistic expectation. What is worthwhile, however, is to replace the missing external cues: set times for drinking and breaks that are tied to the clock rather than to how you feel, along with jointly identifying bodily signals at the exact moment they occur (e.g., “Your stomach is growling—that means you’re hungry”). This gradually creates a connection that wouldn’t otherwise develop on its own. Sometimes a questionnaire can also help assess how much the perception differs. And one point that’s rarely mentioned: parenting or discipline play hardly any role here, and putting more pressure on the child usually makes things worse.
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