Autism and Interoception: Why People with ASD Have Trouble Listening to Their Bodies

It is common for children with autism to seem to struggle with the interpretation of their bodily signals, which can contribute to issues like bedwetting, bathroom urgency, eating or drinking too much or too little, problems with emotional regulation, and more. For example, people on the spectrum may be oversensitive to the feeling of a scratchy tag or shirt but not sensitive enough to the feeling of pain when they actually injure themselves.

Interoception refers to our ability to perceive and integrate the collection of internal signals our bodies send us. We all have these signals, but some people are more in tune with them than others. Research now suggests that people, or at least children, on the autism spectrum often lack the ability to accurately perceive and interpret these signals, which is a large part of what leads to the issues mentioned above.

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Dr. Raymond Chan and his team from the Institute of Psychology of the Chinese Academy of Sciences investigated this topic further with a revolutionary new tool. They developed an Eye-tracking Interoceptive Accuracy Task (EIAT) test to measure children’s interoception accuracy. The test involved showing children two bouncing shapes on a screen and asking them to watch the one that bounced at the same rate as their heartbeat.

Dr. Chan’s eye-tracking system does not require the use of any keys or verbal speech and is therefore very versatile and useful for children with speech impediments or physical disabilities. It might also be useful for pre-school aged children who aren’t familiar with the use of computer keys or don’t have full command of spoken language yet.

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Dr. Chan and his team used the system to measure the interoception accuracy of 30 children with autism spectrum disorder, 20 children with comorbid autism and ADHD, and 63 children who had not been diagnosed with either autism or ADHD but who had high or low levels of autism-like traits.

What the team discovered was that children with autism, whether or not they had ADHD, were less able to feel their heartbeats and follow the movement of the corresponding shape with their eyes. Among the children without autism or ADHD, the presence of more autism-like behaviors also correlated with decreased interoception accuracy.

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What does this research mean for the future of autism care? We use the information we get from interoception to decide when and how much to eat and drink, when to use the bathroom, which way to go on “gut instinct” decisions, and more. We also use it to help us know what emotions we’re feeling and to help us determine what types of emotions the people around us might be feeling. These are all areas that people with autism might struggle with, but it’s possible that practicing listening to their heartbeats and other signals their bodies give them will help children with autism perform better at these tasks.

Photo: Adobe Stock/L Ismail/

We hope that knowing more about the connection between interoception and its related tasks will help autism parents and educators work better with children on the autism spectrum. It might take more effort for these kids to learn to listen to their bodies, but it’s certainly worth trying to teach that skill.

On top of improving how children with autism communicate with their bodies, this research may also help increase the number of early autism diagnoses, as we can now see that lack of interoception skills is a potential symptom of autism.

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