The Shocking Reason Why Some Kids Can’t Tell When They Need to Go

Interoception and Toileting in Early Childhood. Interoception, the ability to perceive and understand internal bodily sensations, plays a crucial role in various aspects of human functioning, including toileting behaviors. This review examines the current evidence on interoception in infants and young children, with a focus on its implications for toilet training and early toileting skills.

Interoception in Early Development

Research has shown that interoceptive abilities begin to develop in infancy. A study by Maister et al. (2017) demonstrated that 5-month-old infants could distinguish between synchronous and asynchronous cardio-visual stimuli, suggesting an early sensitivity to interoceptive signals^[5]. This foundational ability may serve as a precursor to more complex interoceptive awareness in later development.

As infants grow, their interoceptive abilities continue to evolve. Murphy et al. (2017) proposed that interoception processing in children develops from scattered internal bodily information to a more integrated and unified internal representation^[10]. This progression is crucial for the development of body awareness and self-regulation skills.

Interoception and Toileting

The relationship between interoception and toileting behaviors is particularly relevant in early childhood. Mahler (2019) highlighted that children with poor interoceptive awareness may struggle to recognize when they need to use the toilet, potentially leading to difficulties in toilet training and accidents^[4].

Ochsenbein (2020) emphasized the importance of addressing interoception in children with toileting issues, suggesting that many professionals, including doctors and occupational therapists, may not be aware of this sensory system’s role in toileting behaviors^[8]. This lack of awareness can result in prolonged struggles with toileting throughout childhood.

Strategies for Building Interoception

Several evidence-based strategies have been proposed to support the development of interoception in young children, particularly in relation to toileting:

1. Narration and Language Use: Mahler (2019) recommends using “interoception talk” or “body talk” from an early age^[3]. This involves caregivers verbalizing their own bodily sensations and encouraging children to do the same.
2. Visual Supports: Ochsenbein (2020) suggests using visual schedules for bathroom breaks and creating social narratives about the toileting process^[8].
3. Body Awareness Activities: Yoga and mindfulness exercises have been proposed as effective ways to enhance body awareness and interoceptive sensitivity in children^[7].
4. Temperature Activities: Exploring hot and cold sensations can help children develop a better understanding of their body’s temperature regulation, which is often linked to interoceptive awareness^[7].
5. Emotion Recognition: Activities that help children identify and express emotions can also support interoceptive development, as emotional states are closely tied to bodily sensations^[7].

Conclusion

The development of interoception in early childhood appears to be a critical factor in successful toilet training and the acquisition of independent toileting skills. While more research is needed to fully understand the relationship between interoception and toileting behaviors, current evidence suggests that supporting interoceptive awareness through targeted activities and strategies may be beneficial for children struggling with toilet training.

Citations:
[1] https://www.familyconnections.com.au/navigating-toileting-challenges-the-role-of-interoception-in-children/
[2] https://growinghealthyseasons.com/an-interoceptive-perspective-on-toilet-training/
[3] https://www.kelly-mahler.com/resources/blog/interoception-and-early-learners/
[4] https://www.kelly-mahler.com/resources/blog/toileting-interoception/
[5] https://pmc.ncbi.nlm.nih.gov/articles/PMC5548485/
[6] https://www.nature.com/articles/s41598-023-35851-9
[7] https://www.growinghandsonkids.com/10-interoception-activities-and-strategies-for-kids.html
[8] https://sensoryhealth.org/node/1073
[9] https://missjaimeot.com/toileting-sensory/
[10] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8900726/