Thursday, December 13, 2018
Interoception, Autism, and Food
I am sure you are asking yourself what the heck is interoception? I had not heard of it either until recently. Interoception, as we will be discussing today, did not really come about until the start of the 21st century. The overall definition has various interpretations; however, in this discussion, we will talk about inclusive interoception as an umbrella term to mean all experiences of sensation and consciousness that are the result of information to the brain by the central nervous system.
Interoception plays a role in so many systems in the body such as: pain, medically unexplained symptoms, anxiety, emotions in general, emotional regulation, decision -making, time perception, food and water intake, eating disorders, self-awareness, consciousness, addiction, sexual functioning, empathy, meditation, and hypnosis.
Children with interoception can have issues with food intake. A child may have a high desire for food to the point of eating when they are no longer hungry or the opposite problem, they do not want to eat and rarely, if ever, experience the sensation of hunger. Interestingly, I had one of each in this category.
Margaret had many issues when she was young, and I knew they were odd, but I did not know what to make of her quirky behaviors. One of her quirky behaviors was her LOVE of french fries! That girl did not eat much. Heck, she was on the 3rd percentile for a long time in height and weight, but when it came to french fries (or a few other preferred foods) she would eat them until she vomited.
I am not sure how many times I had to apologize to parents and staff at the McDonald's restaurant near us when Margaret ate too many fries and vomited in the Playplace. The parents would look at me and think Margaret had a stomach flu or something and the poor staff at the McDonald's were disgusted. I get it. I was too but I did not realize what was going on at the time. It would be another 6 months before I realized Margaret had MAJOR sensory processing issues and would be diagnosed with autism. Margaret's issues with overeating were due to interoception. When the pleasure center of her brain is turned on eating HIGHLY preferred foods, she would not receive internal signals saying she was full so she would keep eating until she vomited.
Joseph was a complete opposite of Margaret. Where she would eat until she would vomit, Joseph would not eat. He was orally VERY defensive. Again, I know this now, but I had NO idea why he would not eat baby food! He would ONLY open his mouth for the nipple of a bottle. It wasn't until Joseph had OT to desensitize his mouth (again, no one explained about sensory processing disorder to me at that time) and work with a feeding therapist did Joseph get to a point where he could eat Stage 2 baby food without refusal or choking. He was 18 months before he started to eat any sort of food. I had no idea his sensory issues would be so profound.
It was, and to some extent still is a CHORE to get him to eat! He would button his lips SHUT if you came at him with a spoon. He would even do that with the nipple of a bottle until he could feel the texture of the nipple and then he would open his mouth. He NEVER seemed to have an internal sense of hunger. Even now, he is about to be 11 years old, an though he is the size of a 6 year old in height, he weights only 45 pounds. He has seen a nutritionist since he was a year old and has supplements to add to his food to increase the calorie content of the food, yet he never appears to gain weight. Internally, he is rarely hungry. He has gotten up in the morning and would not request to eat anything until dinner (I experimented one day to see if there was ANY internal drive to eat; thankfully there is, barely). Joseph struggles to eat because he body and his brain do not tell him he NEEDS to eat nor does his body seem to light up the reward center of his brain by eating. Again, this is an issue with interoception.
The concept of interoception has been around for awhile but the "new" science on interoception is taking the concept in interesting directions. New medical journal articles are coming out fairly regularly. I feel like we will be hearing more and more about our "8th sense" and how it impacts children with disabilities.
All research for this article is embedded into the article's links. You are welcome to join us for more discussion on ADHD at our FB group, IEP/504 Assistance for parents of public school students from all over the United States, or at our homeschool group, Homeschooling Special (Needs) Kids. We also have a group for all parents and caregivers of special needs children called Special Needs Parenting Advice and Support where we discuss ALL things related to special needs care.