Investigating interoception and body awareness in adults with and without autism spectrum disorder.

Fiene et al. (2015) asked adults with and without autism to fill out two short surveys. One asked, “How well do you notice body signals like hunger or heart beat?” The other asked, “How well do you notice thirst?”

The team then compared the scores between the two groups.

Adults with autism gave themselves much lower ratings on both surveys. They said they often miss body cues and rarely notice thirst.

The gap was large enough that the authors call it a clear interoceptive problem.

Ben Hassen et al. (2023) saw the same pattern and linked it to emotion regulation. They found that poor body awareness, alexithymia, and emotional meltdowns cluster together in the same adults.

Asada et al. (2018) used a body-size task instead of surveys and still found adults with autism mis-judge their own width. The deficit shows up across different kinds of body awareness.

Shawler et al. (2021) warns that survey scores may reflect anxiety, not true ability. They argue that low ratings could be worry about body feelings, not missing them. This view clashes with Fiene et al. (2015), yet both papers use the same tool. The difference is in how we read the score: deficit or distress.

If a client skips meals, ignores thirst, or seems surprised by pain, screen for interoceptive issues. Use simple check-ins like, “Rate your hunger 0-5 right now.” Pair these with visual cues (water chart, snack chart) so the client learns to act before the body signal fades. Teaching body cues can boost self-care and reduce problem behavior rooted in discomfort.