Interoception: Body Awareness Exercises

What is Interoception?

Many of us understand and explore the world through the five senses: touch, smell, taste, sight, and hearing. But there’s another important sense called interoception. This sense helps us become aware of signals from inside our body, like feeling our heartbeat, noticing when we’re hungry, or realizing we need to use the bathroom. 

Interoception means feeling and making sense of (sensing) messages from inside our body, like when our stomach tells us it’s time for a snack, or when our heart starts to race. We don’t focus on these messages all the time, but there are moments, like when we have to speak or present in front of the class, or when we’ve seen something scary on television, or have been very late for something important, that we might feel our heart thumping really hard. Different parts of our brain keep an eye on these inner signals, making sure everything is working well and trying to give us awareness (giving us a heads-up) in case we need to make a change, like get a snack, take a break, or use the bathroom.

Think of it this way: your brain acts as a helpful guide, noticing things like when you might need a drink because you’re getting a bit thirsty. It’s like your body’s alarm system, making sure everything stays just right. The balance – when things are all working right – is called homeostasis. It’s the way our body works to keep us healthy, safe, and feeling comfortable, almost the same as when we sweat to cool down if we’re too warm. For some, awareness and response are automatic, but for others, there can be a disconnect. Body awareness exercises can help develop better interoception and lead to homeostasis – a best state of health and safety. 

Body Awareness Exercises for Autistic People

Body awareness exercises for autistic people can help them develop a better understanding of their internal sensations and emotions. These exercises can be adapted to interests and sensory preferences, so look for teachable moments in your daily routines and preferred play activities. 

Sensory Exploration – Outside In

External sensory experiences have an impact on what happens internally. When engaging in sensory exploration, be mindful of how each activity either calms or excites you.

  • Use textured materials like fabrics, sponges, or sensory balls.
  • Dig into sensory bins. Note how the textures and movement feel, and notice its calming effects.
  • Explore different textures (sand, playdough, textured fabrics) and discuss how each texture feels against the skin.
  • Engage in mindful eating activities, paying close attention to the tastes, textures, and sensations while eating.
  • Lie down on a large sheet of paper and have someone trace your body outline. Then, color or label different sensations you feel in each body part.
  • What’s that smell? Choose favorite scents and talk about how the fragrances make you feel. 

brightly colored sensory bin

Movement Games

  • Simon Says: Play a game of Simon Says with movement commands that target specific body parts (touch your toes, clap your hands).
  • Dance or Follow-the-Leader: Encourage imitation of various movements and poses.
  • Lie down or sit comfortably and guide attention to different body parts, and notice sensations, tension, or relaxation.
  • Child-friendly yoga poses that focus on different body parts, such as Tree Pose, Cat-Cow, and Bridge Pose, can promote body awareness.
  • Tense and relax different muscle groups while discussing how it feels to tense and then release the tension.

four children in yoga poses

Mirror Activities and Emotions

  • Stand in front of a mirror and make faces to recognize facial expressions associated with different emotions. Imitate your mirror partner’s gestures and expressions.
  • Mimic different body movements and gestures to increase self-awareness.
  • Act out different emotions and discuss the physical sensations associated with each emotion.
  • Use a visual “emotion thermometer” to help identify and rate your current emotional state and associated physical sensations.
  • Guide someone, or have someone guide you, through a calming and sensory-rich imaginary experience, such as walking on a sandy beach or exploring a forest.

Mirror games with adult imitating child

Breathing Exercises

  • Inhale slowly through the nose, imagining inflating a balloon in the belly, and exhale through the mouth to deflate the balloon.
  • Hold a feather close to the nose and practice inhaling and exhaling gently to make the feather move.
  • Place a small object (feather or cotton ball) on your stomach and breathe in and out to make the object move.
  • Blow bubbles

father and toddler blowing bubbles


Interoception and Occupational Therapy (OT)

Occupational therapy (OT) for interoception involves structured interventions and activities designed to enhance awareness and understanding of internal bodily sensations.

Assessment and Baseline: Begin with an assessment to determine current level of interoceptive awareness and identify specific areas of difficulty. This baseline will guide the development of a tailored intervention plan.

Education: Provide information about interoception and its importance. Communicate that internal sensations provide valuable information about their body’s needs and emotional states.

Individualized Goals: Collaborate to set interoception-related goals and track progress over time.

Communication Skills: Learn to communicate internal states to others. This is particularly important for people who struggle to express their needs or discomfort.

Visual Supports: Use visual aids, charts, or diagrams to help understand and express internal sensations.

Biofeedback: Use biofeedback devices to visually or audibly represent physiological processes like heart rate or breath. This helps make the connection between internal sensations and these processes.

Hygiene Routines: During hygiene activities, notice how different sensations change during tasks like brushing teeth, washing hands, or taking a shower.

Environmental Sensations: Explore different sensory experiences in the environment, such as temperature changes or textured surfaces, and discuss how these sensations affect the body.

Mindfulness Practices: Incorporate mindfulness techniques, such as body scans and mindful breathing, to help focus on internal sensations and recognize changes as they occur.

Emotion Regulation: Teach emotional awareness and regulation strategies. Identify bodily cues associated with different emotions and develop coping skills to manage emotional responses.

Social Interaction Activities: Incorporate activities that involve social interactions, helping to recognize and respond to social cues related to emotions and bodily states.

Daily Journals: Keep a daily journal to record experiences, emotions, and bodily sensations. This practice promotes self-reflection and awareness.

Interoceptive Challenges: Gradually introduce activities that challenge interoceptive awareness, such as eating spicy foods, engaging in physical activities, or meditating.

Visit the OT ToolboxWhat You Need to Know about Interoception


Interoception is often referred to as the “hidden sense,” and this hidden sense helps us understand  body signals, like hunger, thirst, and emotional states. This self-awareness fosters a sense of well-being and it can help us communicate needs more effectively. By honing interoceptive skills, we can help recognize and manage internal messages, leading to greater self awareness and self regulation. 


Crawling – An Important Milestone in Human Brain Development

Parents of autistic children often share that their child did not crawl, and this factor is commonly underestimated. Those who have little ones who seem to simply sprout from scooting to standing to walking (even delayed) may feel as if the child has made great strides, but it’s important to recognize that crawling helps the brain develop. While scooting is absolutely adorable, crawling affects the brain in different ways. 

Baby in a scooting position

Scooting is fine but encourage crawling, too

Crawling as a Foundation for Cognitive and Motor Skills

Crawling plays a vital role in the early stages of human brain development, laying the foundation for various cognitive and motor skills. As infants begin to crawl, they engage in a complex process of sensory exploration and integration. This physical activity enhances the brain’s ability to create neural connections, facilitating the development of spatial awareness, hand-eye coordination, and proprioceptive skills.

Crawling also fosters the growth of the corpus callosum, a bundle of nerve fibers that connects the two brain hemispheres, promoting communication and information exchange between brain regions. The symmetrical and rhythmic movements involved in crawling have been shown to contribute significantly to the development of a well-connected and efficient brain architecture.

Studies on Crawling and Early Brain Development

Numerous studies have delved into the significance of crawling in early brain development. Research conducted by Karen Pape, a pediatric neurologist, highlights the essential role of crawling in forging neural connections and its influence on overall cognitive and motor development. A study published in the Journal of Neuroscience reveals that crawling babies exhibit enhanced spatial memory and a greater ability to perform tasks that require coordinated movement. Additionally, Neuroscientists such as Dr. John Ratey have explored how physical activities like crawling contribute to the release of brain-derived neurotrophic factor (BDNF), a protein essential for neuroplasticity and cognitive growth.

Encourage Crawling

Encouraging crawling in infants and providing them with safe and supportive environments to explore their motor skills can have far-reaching implications for their cognitive development. As demonstrated by scientific research, crawling sets the stage for improved brain connectivity, essential motor skills, and spatial awareness. And understanding the importance of crawling can guide parents, caregivers, and educators in fostering a child’s early development and providing them with a strong foundation for future learning and overall brain health.

Activities that Mimic Crawling

Activities that mimic crawling can help infants develop their motor skills, coordination, and strengthen their muscles. While infants may not be crawling independently yet, these activities can encourage them to practice the movements and prepare them for the milestone. Here are some activities you can try:

  1. Tummy Time: Place your baby on their tummy on a soft and safe surface. This position encourages them to lift their head and chest off the ground, strengthening their neck, back, and shoulder muscles – essential for crawling.
  2. Baby Plank: While your baby is on their tummy, gently support their upper body by holding their arms. This will help them practice the plank-like position that they will use when crawling.
  3. Rolling Games: Help your baby roll from their tummy to their back and vice versa. This motion helps them build core strength and improves their ability to change positions.
  4. Crawling Tunnel: Create a soft and safe crawling tunnel using cushions or blankets. Lay your baby on their tummy at one end and encourage them to move through it using their hands and knees.
  5. Crawl-and-Reach: Place toys just out of your baby’s reach while they are on their tummy. Encourage them to move towards the toys by crawling or scooting.
  6. Parent-Assisted Crawling: Sit on the floor and position your baby on your legs facing you. Gently help them move forward by holding their hands and guiding them through the crawling motion.
  7. Mirror Play: Place a baby-safe mirror in front of your baby while they are on their tummy. Babies are often fascinated by their reflections and may try to reach out to the “other baby,” promoting movement.
  8. Carpet Slide: Place your baby on a soft carpet or mat and gently pull them across the floor, allowing them to experience the crawling motion without using their own muscles.
  9. Crawling Race: If you have friends with babies around the same age, organize a mini-crawling race. Line up the babies and encourage them to crawl towards a fun toy or their parents waiting at the other end.

Remember, each baby develops at their own pace, and it’s essential to create a safe and supportive environment for them to explore and practice these movements. Always supervise your baby during these activities, and if you have any concerns about their development, consult with a pediatrician or child development specialist.

Resources:

  1. Pape, K. E. (2008). The role of early general movement assessments as predictors of cerebral palsy. The Neurologist, 14(6), 331-340.
  2. Adolph, K. E., & Berger, S. E. (2006). Motor development. Handbook of child psychology, 2, 161-213.
  3. Lobo, M. A., & Galloway, J. C. (2013). Crawling and walking infants elicit different verbal responses from mothers. Developmental science, 16(6), 894-905.
  4. Ratey, J. J. (2008). Spark: The Revolutionary New Science of Exercise and the Brain. Little, Brown Spark.

Light Box Activities for Autistic People: J.J. Sedelmaier Shows us the Light

Autism Connection of PA received a special donation from J.J. Sedelmaier Productions in White Planes, New York. Sedelmaier is an animator, film producer, author, illustrator, and a creative force who understands the importance attention, art, and design. He donated a light box for Autism Connection to use for activities for people of all ages and stages on the autism spectrum. 


How Light Boxes Help

Using a light table can be a highly beneficial tool for supporting the development and engagement of autistic people of all ages and stages. The soft, diffused light emitted from the table provides a visually stimulating and calming environment, which can help regulate sensory experiences. The translucent surface allows for the exploration of various materials and objects placed on top, enabling users to engage in sensory play, fine motor skill development, and visual tracking exercises.

The illuminated table also enhances visual attention and focus, making it an excellent tool for activities such as tracing, drawing, and learning letter and number recognition. And the versatility of a light table encourages imaginative play and creativity, allowing autistic people to express themselves and engage in meaningful, multisensory experiences. Overall, incorporating a light table into the learning and therapeutic environment can facilitate their sensory integration, cognitive development, and overall well-being.

List of Light Box Activities 

  • Shadow Play: Use the light box to create shadow puppets or objects. Experiment with different hand gestures and shapes to create original shadow stories.
  • Tracing Art: Place a piece of paper on the light box and trace favorite characters or objects. They can color in the traced image afterward to create their own artwork.
  • Tangrams: Provide tangram puzzle pieces and arrange them on the light box to create various shapes, animals, or objects. It’s a great way to enhance spatial reasoning and problem-solving skills.
  • Sensory Play: Fill transparent containers with colorful objects, such as beads, feathers, or buttons, and place them on the light box. Explore and sort the items based on different attributes like size, shape, or color.
  • X-ray Play: Gather various objects, like toys or natural objects, and place them on the light box. Observe the objects from the top and explore their internal structures, mimicking an X-ray effect.
  • Color Mixing: Place translucent colored materials, such as plastic sheets or stained glass shapes, on the light box. Overlap different colors and observe how they blend and create new shades.
  • Letter and Number Recognition: Use transparent letter or number tiles on the light box and arrange them in alphabetical or numerical order. This activity helps reinforce letter and number recognition skills.
  • Storytelling: Provide transparent story cards or characters and create stories on the light box. Arrange the characters, props, and backgrounds to bring imaginative tales to life.
  • Science Experiments: Conduct simple science experiments on the light box, such as exploring the properties of different liquids, observing the growth of plants or crystals, or investigating the refraction of light through various materials.
  • Building with Blocks: Combine transparent or translucent building blocks with the light box to create structures with varying colors and shapes. Experiment with balance, stability, and symmetry.

Big thanks to J.J. Sedelmaier for the donation. It will be put to good use. 


Megan Montague Cash Receives Autism Connection of PA Certificate of Appreciation

Megan Montague Cash has dedicated her career to illustrating and designing for children – all children. She routinely asks for insight and feedback from the autism and disability communities as part of her project, Designing for Children with Learning Differences at Pratt Institute School of Design in Brooklyn, New York. Autism Connection of PA is thrilled to be part of the feedback loop, and we look forward to Megan’s future projects as well as the amazing designs her students create.

 

Certificate of Appreciation Presented to Megan Montague Cash in recognition of her work



Letter of Appreciation

Dear Professor Montague Cash,

Autism Connection of Pennsylvania deeply appreciates and recognizes the invaluable contributions you have made in inspiring students, educators, and professionals to cultivate inclusive environments that promote growth, development, and learning for children with autism and learning differences. Your unwavering dedication, passion, and innovative teaching methods have nurtured an inclusive mindset, leaving a profound and lasting impact on the lives of numerous children and their families.

In sincere acknowledgment and deep gratitude for your exceptional achievements in the field of education and your relentless commitment to designing for children with autism and learning differences, we commend the remarkable work you have accomplished at Pratt’s Designing for Children with Learning Differences. Your exemplary efforts have exemplified an extraordinary dedication to fostering inclusivity and understanding for people on the autism spectrum.

Through this certificate, we honor your unwavering dedication, passion, and tireless endeavors in advancing the field of education and making a positive difference in the lives of autistic children and children with learning differences. Your legacy as an exceptional educator, who has dedicated their career to designing and illustrating for children, will resonate for generations to come. On behalf of the Autism Connection of Pennsylvania, we proudly present you with this Certificate of Appreciation, signed and sealed on this 28th day of June, 2023.


Learn more about Megan’s work at Design for Kids.



Measurable IEP Goals that Address Executive Functioning: Enhancing Student Success

In the realm of special education, Individualized Education Programs (IEPs) play a crucial role in supporting students with diverse learning needs. When it comes to addressing executive functioning skills, creating measurable goals within the IEP is essential. Executive functioning refers to a set of cognitive processes that enable people to plan, organize, manage time, pay attention, regulate emotions, and demonstrate self-control. By incorporating measurable IEP goals that target executive functioning, educators can provide effective interventions and support students in achieving their fullest potential.

Understanding Executive Functioning

Executive functioning encompasses various skills that facilitate goal-directed behavior and cognitive flexibility. These skills are important for academic success, social interactions, and independence. The core components of executive functioning include:

  1. Working memory: The ability to hold and manipulate information in mind while performing tasks.
  2. Cognitive flexibility: The capacity to adapt to new situations, shift perspectives, and switch between tasks.
  3. Inhibition: The skill to inhibit impulsive actions, control attention, and stay focused.
  4. Planning and organization: The ability to develop a plan, set priorities, and manage time effectively.
  5. Self-monitoring: The capacity to evaluate one’s own performance, regulate behavior, and make adjustments as needed.

Learn more about executive functioning by following the link below:

Everything Executive Functioning Handbook


Creating Measurable IEP Goals

When developing measurable IEP goals that address executive functioning, it is important to follow the SMART criteria:

  1. Specific: Goals should be specific and clearly define the desired skill or behavior. For example, “The student will improve working memory skills by being able to remember and follow multi-step directions in 80% of classroom tasks.”
  2. Measurable: Goals should be measurable, allowing educators to track progress and determine if the goal has been achieved. For instance, “The student will demonstrate improved cognitive flexibility by successfully switching between academic tasks with minimal support in 90% of observed instances.”
  3. Attainable: Goals should be realistic and attainable within a reasonable timeframe. It is important to consider the student’s current level of functioning and set goals that challenge but do not overwhelm them.
  4. Relevant: Goals should be relevant to the student’s educational needs and directly address their executive functioning deficits. They should align with the student’s academic and functional requirements.
  5. Time-bound: Goals should have a specific timeline or deadline for completion. This ensures that progress can be monitored regularly and interventions can be adjusted if necessary.
smart goals logo

Sample Measurable IEP Goals

  1. Goal: The student will improve working memory skills.
    • Objective: The student will remember and follow multi-step directions in 80% of classroom tasks within six months.
  2. Goal: The student will enhance cognitive flexibility.
    • Objective: The student will successfully switch between academic tasks with minimal support in 90% of observed instances within three months.
  3. Goal: The student will develop effective planning and organization skills.
    • Objective: The student will independently create and utilize a daily planner to manage assignments and deadlines in 100% of subjects within four months.
  4. Goal: The student will enhance self-monitoring skills.
    • Objective: The student will evaluate their own performance, identify areas for improvement, and make appropriate adjustments in 80% of academic tasks within five months.

Implementing Measurable IEP Goals

To effectively implement measurable IEP goals targeting executive functioning, educators should:

  1. Collaborate with relevant stakeholders, including special education teachers, general education teachers, parents, and the student, to ensure consistency across settings.
  2. Provide explicit instruction and scaffolding to support the development of executive functioning skills.
  3. Incorporate strategies such as visual aids, checklists, graphic organizers, and timers to facilitate planning, organization, and time management.
  4. Regularly review and assess progress towards the goals, adjusting interventions and supports as needed.
  5. Offer opportunities for practice and reinforcement of executive functioning skills across different subjects and contexts.
  6. Provide feedback and praise to encourage and motivate the student’s progress.
  7. Foster a supportive and inclusive learning environment that values and acknowledges the student’s efforts and growth.

40 IEP Goals for Executive Functioning Skills


Measurable IEP goals that target executive functioning skills are instrumental in supporting students with a wide range of learning needs. By incorporating these goals into individualized education plans, educators can provide targeted interventions that can support students in developing essential cognitive processes that promote academic success and independence. With clear, specific, and measurable goals, educators can effectively track progress, adapt strategies, and ensure that students have the necessary tools to overcome executive functioning challenges and thrive in their educational journey.


Bereft of Coffee

While waiting for the coffee to finish brewing in the office kitchenette, my eyes fixated on the stream of coffee entering the carafe and the tranquil sounds it made in anticipation of the final surge of steam as the brewing finished.  This concentrated focus drowned out a number of elements that flooded the surroundings, flickering lights, multiple distant voices, phones ringing, and the general energy of movement within the maze of cubicles.

During the reverie, I saw a peripheral figure approaching to my left, and a soft, clear voice flowed into my ears, “Good morning! How are you?” and at that moment, I straightened and turned my entire torso toward the person asking the question, stopping like a machine that produced speech. I heard my own voice say, “I am bereft of coffee.” And all memory of the moments following would never gel in my mind because I could only fixate on my social ineptitude.

Bereft of coffee. Who says that? Did you even make eye contact?

Bereft

Bereft is not a word used often in everyday conversation. It’s a complex, haunting word that comes from bereave, a term of loss and mourning that communicates that something is lacking.

A graph showing the usage of the word bereft over the years with a slight uptick in 2019

Yes. I looked up the use of the word “bereft” over time. It really took a dip in the 1940s and I’ll probably try to find out why.


In the morning kitchenette interaction, the thing that was lacking was coffee, and the choice of the word bereft in this specific case seems a bit dramatic. The word may also communicate on some level that I really want to interact on your terms, but I just don’t know how. It takes a great deal of concentration and sometimes the words just pour out and I wish I could collect them and rearrange them into something, well, “normal.”

The coworker who kindly asked the question was likely to think, “Well, that was an unusual response,” and the moment would vanish along with the multiple mundane things that occur in a nondescript workday. But for me, this common office interaction became a source of shame that lingered for months. This wave of embarrassment was probably unnecessary but it is something that people on the autism spectrum face when they are aware of basic communication differences that can sometimes lead to misunderstanding.

Full Cup

When we have people who truly understand communication differences, we find that they often see these types of interactions insightful, and sometimes endearing. While lamenting to a trusted coworker about my perceived social awkwardness, she said how lovely it was that I was able to express such a deep love for coffee, and in turn, a deep appreciation for words. Bereft is a beautiful word that can express longing for acceptance, and even longing for something comforting, like a cup of coffee.

 

 


Identifying Autism in Adults

The autism spectrum is broad, varying features that are sometimes difficult to recognize on the surface. Some adults may have lived their lives without a full awareness that some of the barriers and struggles they have faced are a result of undiagnosed autism. Reports include those who have been stunned by the direct question, “When were you diagnosed with autism?” Other reports specify experiencing difficulty understanding social interactions, difficulty with tolerating textures, changes in routines, and being genuinely dumbfounded by other people’s seemingly insensitive perspectives and behavior. Those reporting range in ages from 20 to 64 years old.

At Autism Connection of PA, Chrisoula manages hundreds of calls, emails, and website contact entries each month. She offers suggestions to adults who want to identify the signs of adult autism, getting diagnosis, and finding support and resources.

-TLM


Identifying Signs of Autism in Adults

While autism is commonly associated with childhood, it is crucial to acknowledge that many people may remain undiagnosed until later in life. Some prevalent signs and characteristics that may indicate autism in adults include:

  1. Social Communication Differences: Difficulty comprehending and utilizing nonverbal cues, challenges in sustaining conversations, and struggles with recognizing and expressing emotions
  2. Sensory Sensitivities: Heightened sensitivity or aversion to specific sounds, sights, textures, tastes, or smells
  3. Special Interests and Routines: Intense focus and extensive knowledge in particular areas of interest, accompanied by a preference for routines and consistency
  4. Executive Functioning Challenges: Difficulties with organization, time management, planning, and flexible thinking
  5. Social Interaction Difficulties: Feeling overwhelmed in social situations, experiencing difficulties in establishing and maintaining friendships, and struggling to grasp social nuances

Pursuing a Diagnosis

If you suspect that you may have autism or exhibit some of the aforementioned signs, it is important to seek a formal diagnosis. Here are the steps you can take:

  1. Educate Yourself: Acquire knowledge about autism in adults and familiarize yourself with the diagnostic process. Learn about common traits and characteristics associated with autism. Weekly e-news covers a range of topics. 
  2. Consult Professionals: Reach out to healthcare providers, psychologists, or diagnosticians who specialize in assessing autism in adults. They can guide you through the evaluation process.
  3. Diagnostic Assessment: The assessment typically involves interviews, questionnaires, and observations to evaluate your social, communication, and behavioral patterns. The goal is to gain a comprehensive understanding of your experiences and determine whether autism is an appropriate diagnosis.

Support and Resources

Following a diagnosis, people with autism can access various forms of support to enhance their well-being and quality of life. Here are some beneficial resources:

  1. Therapy and Counseling: Engage in individual or group therapy sessions with professionals experienced in working with adults on the autism spectrum. Therapy can focus on developing social skills, regulating emotions, and addressing specific challenges.
  2. Skill Development Programs: Seek out programs that offer training in areas such as executive functioning, communication, and social skills, tailored to the specific needs of adults with autism.
  3. Support Groups and Communities: Connect with local or online support groups where you can meet others who share similar experiences. These groups provide opportunities to share insights, receive emotional support, and connect with others on a similar journey. We offer several support groups for you to join!

Recognizing signs of autism in adulthood, pursuing a diagnosis, and accessing support are crucial steps toward understanding oneself and navigating life with autism. By staying informed, seeking professional guidance, and utilizing appropriate resources, autistic people can embark on a path of self-acceptance, growth, and fulfillment. Remember, Autism Connection of Pennsylvania is here to support you every step of the way.

–Chrisoula Perdziola, Resource Specialist

[email protected]