Recent research indicates that Interoceptive Awareness (e.g., conscious awareness of pain, affective touch, heart rate, etc.) is integrated with Sensory Processing input (e.g., fast brushing, movement,
touch, deep pressure, 
,
vibration, 
sound, & sight) in the middle Insular Cortex (Craig, 2014). These new neurological findings form a theoretical foundation for recent research showing the efficacy of clinical interventions that assess and enhance interoceptive awareness in clients with Autism Spectrum (DuBois et al., 2016; Mahler, 2017), Post-Traumatic Stress Disorder (Brown & Gerbarg, 2012), chronic pain, Anorexia, and other mental health disorders (Price & Hooven, 2018).
Research and clinical experience suggest the efficacy of individually combining interoceptive awareness, sensory processing, behavioral (Khalsa et al., 2018) and trauma-informed treatment (Warner et al., 2014). The need to merge sensory integration with interoceptive awareness intervention is supported by emerging clinical evidence demonstrating the effectiveness of sensory integration interventions in PTSD (Warner et al., 2014) and its recent inclusion as an evidence-based treatment for Autism Spectrum Disorder.
Over the past 20 years I have been developing the FAB Strategies curriculum to help youth with complex behavioral challenges. Included are strategies that developmentally address body awareness for improved behavior by combining the interoceptive awareness and sensory integration frames of reference. My recent training in (MABT) Mindful Awareness for Body-oriented Therapy and ARC Trauma Treatment, certificate in PRT applied behavioral analysis, QST massage for Autism, and as a Breath-Body-Mind Teacher has given me a better understanding on how to developmentally integrate the interoceptive awareness, sensory integration, behavioral and trauma-informed therapy frame of reference to provide therapists with a range of treatment options that can be individualized to improve the behavior of youth with complex behavior challenges.
The first step is to assess any Interoceptive Awareness, Sensory Processing, behavioral, and trauma-informed therapy needs of clients who have Complex Behavioral Disorders to develop a comprehensive treatment plan Assessment Post. Following the assessment occupational therapists can collaborate with parents, teachers, as well as speech/language, physical, and mental health therapists to individualize interventions that integrate both the interoceptive awareness and sensory processing frames of reference. My future posts will present practical developmental strategies that can be individualized to improve self-control in youth with complex behavior problems by selecting individualized options that meet their developmental, trauma-informed therapy, sensory integration and body awareness needs. My next posts will consecutively describe several options for the body scan, feel your feet grounding, hand breathe, bird breathe, kindness, and tense & relax FAB Strategies. I hope you find them helpful in working with clients who have complex behavioral, sensory processing and interoceptive awareness challenges.
References
Brown R, Gerbarg P. The healing power of the breath: Simple techniques to reduce stress and anxiety, enhance concentration, and balance your emotions. Shambhala Publications; 2012 Jun 12.
Craig AD. How do you feel?: an interoceptive moment with your neurobiological self. 2014.
DuBois D, Ameis SH, Lai MC, Casanova MF, Desarkar P. Interoception in autism spectrum disorder: A review. International Journal of Developmental Neuroscience. 2016 Aug 1;52:104-11.
Khalsa SS, Adolphs R, Cameron OG, Critchley HD, Davenport PW, Feinstein JS, Feusner JD, Garfinkel SN, Lane RD, Mehling WE, Meuret AE. Interoception and mental health: a roadmap. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging. 2018 Jun 1;3(6):501-13.
Mahler, K. Interoception: The eighth sensory system. 2017.
Price CJ, Thompson EA, Crowell S, Pike K. Longitudinal effects of interoceptive awareness training through mindful awareness in body-oriented therapy (MABT) as an adjunct to women’s substance use disorder treatment: A randomized controlled trial. Drug and alcohol dependence. 2019 May 1;198:140-9.
Warner E, Spinazzola J, Westcott A, Gunn C, Hodgdon H. The body can change the score: Empirical support for somatic regulation in the treatment of traumatized adolescents. Journal of Child & Adolescent Trauma. 2014 Dec 1;7(4):237-46.
