Autism and Interoception

How are you feeling?

Have you ever heard of interoception?
This a sensory function which is still being described, and there is still some disagreement over what its definition should include.

Interoception is the sense of your inner self which includes the ability to feel what is going on inside you.

The initial definitions were about giving a person ability to recognize inner physical symptoms of needs: when you felt hungry, thirsty, needed to go to the bathroom, felt pain or discomfort in your internal workings.

The definition has been refined over time and using recent studies now includes also your emotional status.

Studies are in the initial stages but tend toward showing that neurological ties to the inner body are the same that are used for ‘feeling’ emotions, and that yes, emotions are tied to physical feelings as well.


We all know that, if we think about it. Tension headaches, anxiety stomach aches, the burning that comes with anger and the churning gut of distress, and how do you suppose the term ‘heartache’ was coined?

Right now there is debate over which comes first, the physical sensations or the emotional processes involved in recognizing ones “feelings”. Some scientists are saying that the physical responses are the initial ones which cause us to then recognize the emotions behind them.

I think the jury is still out on that idea, but it is interesting to think about the implications.


Interoception as it is described today is related to recognizing physical and emotional status of our inner selves. It is the neurological sense that tells us ‘how we feel’ in the most literal way.

How is this likely to be tied to autism?

Interoception is believed to exist because of human neurology. It is being defined as another sense.
We are equipped with an internal monitor through a network of nerves which sense and report “how we feel”.

Autism being a function of neurology and strongly tied to sensory processing, can show its effects in any part of the human neurological system.
Many autistic people are not good at recognizing when they are hungry, thirsty, tired, whether their bladder is full, and on and on.
We are notoriously poor at sorting our emotions as well.
All of these issues are related to interoception because they are all issues of sensory processing within us.

I will use imaginary Sally as an example.
Sally was late to be toilet trained, she simply was not able to tell when she ‘had to go”. She often wet the bed. Her body did not wake her when her bladder was full because it did not recognize that discomfort.
Sally had a ruptured appendix when she was 25, and did not recognize the abdominal ache, which she reported as vague and undefined. She finally had uncontrollable vomiting which drove her to the emergency room where she was barely in time for her life to be saved by immediate surgery.
Sally will get so involved in a project that she forgets to eat, and when she finally does eat, she does not know when to stop, often getting sick from overeating.
She is known for her volatile temper and her extreme emotional outbusts.
All those struggles are likely to have their base in processing input from her interoceptive system.

Do you have signs of interoceptive struggles in your own life?

Autism in the Elderly population

How many people are we talking about?

I started wondering yesterday just how many people in the US population 65 and above were likely to be autistic. I have used statistics from the Washington DC based Population Reference Bureau( PRB) to try to figure this out.
According to PRB there are currently 52 million adults over the age of 65 in the United States as of 2018. Our life expectancy is 78.6 years.
Using only these figures and not adding all the missed diagnoses and undiagnosed people under the age of 65, and using the often quoted average of 2 percent of the population as being autistic, I came up with at least 1,040,000.
That many adults may be considered to be Autistic without diagnosis, although of course some of us are now finding diagnosis as autism and its hallmarks are becoming better known.
If we add in the population of adults who are younger than 65, to include the adults from all the years before 1980 when autism was first listed as ‘infantile autism’ in the DSM, you can see there is a need for diagnosis in adults now reaching middle age as well.
If you know 100 adults over age 50, you know at least 2 autistic people among them. My high school graduating class just celebrated its 50th anniversary. There were just over 200 people in the class ( 229). I know I was one of the autistic people in that class and I think I know of at least 2 others who, looking back, would probably be diagnosed as autistic. I wonder if they have any idea they are autistic, or if they still struggle with issues not understanding why, or having tools that could help. How many of us will end our days not ever being aware of why we struggled, never understanding the neurological condition that affects us every day and knowing our problems are not a matter of character, morality, goodness, evil, or inner strength, and never knowing that all our supposed/ believed/ blamed by family and society’s pointing fingers of shame…. never knowing what we think are our personal failures are not our fault?
How many of us need the tools that knowing about our autism provides? I know from personal experience how much better is life from the other side of autism and understanding how it has affected me, affected others through my behavior, affected my life, the choices I made, the things I believed, the things I do… everything looks different from this side of diagnosis. It has made a world of difference to me. I would love to know that others like me, even this late in life, could find the utility of new ways to live, peace and understanding that comes with diagnosis of autism.