Interoception and its application to paediatric occupational therapy: A scoping review.

Abstract

Paediatric occupational therapists assess and provide intervention for children presenting with sensory processing challenges that impact their daily occupational performance. Interoception, the ability to sense internal body signals, is an emerging practice area, yet it remains unclear how and why paediatric clinicians are applying interoception and related concepts in practice. A scoping review was conducted to report on the current body of published literature related to interoception and its application to paediatric occupational therapy practice. A comprehensive search of 10 electronic databases and related grey literature was conducted. Title and abstract screening were completed prior to full-text review of evidence. The PRISMA-ScR Checklist and the Crowe Critical Appraisal Tool were used to support a systematic scoping review process and increase robust extraction and appraisal of data. Narrative synthesis was used to analyse and synthesise data. No consumer and community involvement. A total of 18 articles were included in this review, including original research articles (n= 8), published books (n= 4), theses/dissertations (n= 3), opinion pieces (n= 2), and one government document. Narrative synthesis analysis identified six themes: (1) occupational therapy principles relevant to interoception, (2) what is interoception?, (3) assessment of interoception, (4) clinical application of interoception, (5) clinical populations receiving interoception-based intervention, and (6) relationships between interoception and other performance components. Findings indicated that paediatric occupational therapists are integrating interoception concepts alongside occupational therapy principles to inform assessment and intervention processes. Several assessments and interventions are utilised to support children; however, evidence to strengthen use is lacking. Further, there are limited occupation-based assessments and intervention programs to address interoception deficits in children. Findings from this scoping review contribute to the emerging body of empirical evidence related to interoception and paediatric occupational therapy practice. These findings provide an informed basis for practice and research by occupational therapists in this area. Interoception allows us to feel what is going on inside our body and helps us to notice how our body might be feeling (e.g. if our stomach grumbles, we might feel hungry; if our heart is beating very fast, we might feel scared; if we are sweating, our body is feeling overheated). Some children may present with problems recognising interoceptive feelings in their bodies. Therefore, occupational therapists can help children learn about their own interoception related to their bodies. This is a new topic for therapists, and they need to know more about it so that they best help children and their families. There is not a lot of information about how to use interoception in occupational therapy practice, and we wanted to know what information already exists about interoception and occupational therapy. This review provides a summary of the current knowledge that is available and summarises it. Some information about interoception and how it relates to occupational therapy services with children was found, but more research knowledge about this topic is needed.