The Body's Whisper: Interoception Difficulties and Neurodivergence

I opened the email expecting to spend a minute or two reading my child's Science 8 syllabus and then I would move back to my own homework.

The document outlined course content due dates and reasonable classroom expectations. That is, until it didn't.

Just as I was about to close the tab previewing the PDF, three lines caught my attention.

Students may use the time during class change to eat, drink, and use the restroom. Eating, drinking, and bathroom use are strictly forbidden. In the case of emergency, students may ask the teacher for an exception.

First, I have to say that we love our school. Generally, the teachers and administration are supportive and collaborative when establishing or changing accommodations This, however, was an exception.

Immediately, my mind shot to being 13 and either realizing I had gotten my period or that my anxiety was acting up and I needed to use the washroom... stat. These situations are inherently embarrassing in and of themselves without having to justify my bathroom use and risk being overheard by other 13-year-olds.

I was concerned about the possibility of embarrassment in general. But my greatest concern was for some minortized students.

Having to justify bathroom use is enough to mortify the best of us. But it was likely that it would disproportionately impact menstruating females, students with chronic illness, and neurodivergent students. While all three are important to consider, the reason the bathroom and anti-food/ drink policy may impact neurodivergent students more may be less obvious.

Neurodivergent (specifically ND people who are ADHD or autistic) tend to struggle with interoception.

What is interoception?

Interoception is the ability to read and respond to internal cues like hunger, thirst, pain, temperature, needing the bathroom, heart rate, emotions, and even energy levels. It is one of the eight core sensory systems. We have five senses, as well as the three hidden systems - the proprioceptive (the body's force and position in space movement), vestibular (balance), and interoceptive systems.

Interoception is responsible for reading internal states like:

• Thirst and hunger: Do I need to eat? Am I full?

• Temperature: is my body too hot or too cold?

• Discomfort and pain: where did that bruise come from?

• The need to use the bathroom: Do I notice I need to go before it's an emergency?

• Physiological states like heart rate, breathing rate, and fatigue: Do I notice when my heart rate begins to accelerate and when I need to deep breathe? Do I notice when I'm tired?

• Emotional states like stress, fear, and sadness: When I am exhibiting signs of frustration, can I easily label what's going on?

It’s not just sensing these things—it’s also responding appropriately.

Often the signals we receive feel more like a whisper than a push notification. So it may not dawn on us to grab a sweater, a snack, take a rest, or stop the bleeding. That is until we're so chilled, ravenous, or exhausted that we're pushed past our limits and can no longer function.

Shared Experiences in ADHD & Autism

Although they show up differently, both neurotypes may:

• Miss early body cues - e.g., eating too little or too late, forgetting to take breaks

• Respond suddenly and with urgency when cues register - e.g., the need to use the washroom or eat right now, or intense fatigue that seems to appear out of nowhere

• Experience dysregulation from unnoticed internal signals - e.g., not noticing intense stress until completely overwhelmed

• Be judged for poorly planning or being disruptive due to the urgency and intensity of bodily needs

Key Differences between autism & ADHD

• Age pattern: some autism studies show more reduced interoceptive awareness in children (with partial normalization/compensation in some adults), whereas ADHD findings often hinge on symptom severity and attentional context rather than a clear age pattern.

• Measurement mismatch appears especially prominent in autism: autistic people frequently report difficulties even when task performance is near typical — suggesting differences in how interoceptive signals are interpreted or integrated, not only raw sensitivity. This mismatch is less emphasized in many ADHD studies (though it can occur).

• Neural hypotheses: some autism research emphasizes large-scale neural connectivity as plausible mechanisms; studies in a systematic review link interoceptive variance in ADHD to arousal/attention-regulation systems and executive control. Both point to the insula/brainstem networks but frame the dysfunction differently.