Interoception and feeding differences: Understanding what's really happening beneath the surface

What if our bodies are sending messages we were never taught to understand? For many neurodivergent children, this isn't a metaphor. It's daily reality. Their internal signals, the ones telling them about hunger, fullness, pain and overwhelm, might arrive muted, delayed or all at once in overwhelming intensity. And when it comes to feeding, these differences change everything.

In Episode 16 of the Neurodivergent Pulse podcast, host Laetitia Andrac sits down with Kelly Mahler, an occupational therapist who has been exploring the science of interoception for over two decades. What unfolds is a conversation that reframes how we think about feeding challenges, moving away from judgement and towards deep, compassionate curiosity.

What is interoception?

Interoception might sound like a complex scientific term, but the concept itself is something we all experience. Kelly explains it as "the newest sense that's been identified by scientists," involving receptors throughout our bodies that pull in information about how our body is feeling. Is your heart racing or calm? Is your stomach full, empty, nauseous or gassy? Is your head pounding or clear?

These internal sensations do more than inform us about our physical state. They are the foundation for recognising emotions. As Kelly describes, "being able to notice and really understand these sensations is what helps us know what emotion we're experiencing." Anxiety, for example, shows up differently in each body. For Kelly, it feels like tightness in her chest and heaviness in her head, "like I can't work through this thick mud."

Beyond emotions, interoception helps us recognise essential needs: hunger, thirst, pain, the need to use the bathroom, the need for rest. When this sense works differently, as it often does for neurodivergent individuals, the effects show up throughout daily life.

Muted and intense interoceptive experiences

Research and lived experience are revealing that many neurodivergent people experience interoception differently. Some describe what Kelly calls a "muted interoceptive experience" where body signals are not strong enough to be recognised until they reach emergency level.

This shows up in families in very recognisable ways. "They only notice that they're getting hungry when they are hangry and it's like an emergency must eat situation," Kelly explains. Laetitia immediately relates: "Which is the case in our family. It's like Zoe and I were like, I need to eat now. Like what's happening?" The same pattern appears with toileting, where children suddenly rush to the bathroom, or with emotional regulation, where meltdowns seem to arrive without warning because the earlier signals never reached awareness.

On the other end of the spectrum, some people have an intense interoceptive experience where sensations are felt in very strong, sometimes overwhelming ways. Kelly shares a memorable example:

I had a client a few years ago that every time he ate a meal, he could feel his food moving through his digestive tract. Now, that's a very intense inner experience. It was very hard for him to pay attention to math class after lunch at school because he was having this intense inner experience.

Others describe experiencing "inner chaos" with many signals happening simultaneously, making it difficult to make sense of what their body needs. Importantly, Kelly notes that many people have some signals that are muted and some that are intense, and this profile can change from day to day.

How lived experience shapes interoception

While some neurodivergent people may be born with interoceptive differences, their lived experiences significantly affect how interoception develops over time. And here is where the conversation becomes particularly important for parents, teachers and therapists.

Many neurodivergent individuals face daily invalidation of their inner experiences, often from people with the most loving intentions. Kelly shares an example from her own parenting: when her children were little and would fall and bump their knee, her instinct was to say "Oh, you're fine. It's just a little bump. Just brush it off. Get up, let's keep going." The alternative, she now recognises, is to acknowledge what the child's body is communicating: "I see you're crying. Let's do something together to help your body feel better."

The impact of repeated invalidation runs deep. "They begin to doubt their body," Kelly explains. "If everybody else is telling you that you can't possibly be feeling that, you start to doubt what your body is telling you. Maybe my body's wrong. Maybe these signals that are telling me what I thought they were telling me aren't really reliable or trustworthy."

Laetitia relates to this personally. As a neurodivergent adult, she remembers countless times when sounds felt too loud or lights too strong, only to be told "that's fine." It took experiencing burnout at 30 for her to realise how much energy this constant dismissal was costing her, and to shift her parenting towards honouring her children's inner experiences.

Both Kelly and Laetitia acknowledge that they still sometimes catch themselves invalidating. The key, Kelly suggests, is repair: "When it creeps up and we catch ourselves, I think apologising and just saying, 'I'm so sorry, let me respond to that in a different way,' is extremely validating. It just shows we're trying."

The deep connection between interoception and feeding

When we understand interoception, the relationship with feeding differences becomes clearer. Interoception underlies so many aspects of eating, far beyond simply noticing hunger and fullness. It includes noticing thirst, feeling unsafe in the nervous system, experiencing disgust, sensory overwhelm and pain. All of these internal experiences shape how a person relates to food.

The connection is well-documented. Kelly shares findings from a recent survey of people with feeding differences, specifically ARFID (Avoidant Restrictive Food Intake Disorder):

We asked people with lived experience to answer some questions and 93% of them said that interoception is a big factor in their feeding and eating participation.

This finding highlights how essential it is to pay attention to what the body is communicating during mealtimes. When we can get curious about a child's body signals during eating, we can begin to identify what's causing distress and modify the experience to better match their needs.

Kelly gives a practical example: if a child is highly distressed during meals and, through curiosity, you discover they need their food not to touch, the modification might be as simple as using separate containers. But getting to that solution requires genuine curiosity about what the body is saying, rather than assumptions about behaviour.

Even when curiosity doesn't immediately yield answers, the process itself matters. "I see that something about this scenario is really bothering you. Your body is telling us something, so let's try hard to figure it out," Kelly suggests saying. This approach stands in stark contrast to older feeding approaches that "steamroll over" the body's communication with instructions to "touch your food, lick your food" without understanding why feeding is hard.

Why we need to stop saying "picky eater"

The label "picky eater" came up repeatedly in Kelly's survey, and the message from respondents was clear: we need to stop using this language. It's invalidating to what's actually happening.

The problem with behaviour-based labels is that they give us a quick answer and shut down curiosity. Saying "they're just picky" implies we already know why this is happening, that the child is being difficult or oppositional. It describes a surface behaviour and attaches judgement to it.

Kelly reflects on why we default to this approach: "We like to have answers. So when I say, 'Oh, they're just picky eating,' I'm giving an answer to what I see. Like I already know why you're doing this."

The alternative, trying to understand the deeper "why," requires vulnerability. It means sitting with uncertainty and accepting that we don't have immediate answers. It takes trial and error. But it's the path that actually leads to supporting the child.

Kelly suggests a reframe: "Whenever you see a behaviour happening on the outside, really challenge yourself to think about what could this be telling me about their insides? How could their body be feeling?"

Practical shifts for families and clinicians

Both Kelly and Laetitia acknowledge that shifting from a behaviour-based approach to a curiosity-based one takes practice. Kelly is transparent that early in her 23-year career, she worked in compliance-based, behaviour-focused programmes. Change is possible, and it starts with small shifts.

Here are practical strategies from the conversation:

• Ask questions, even if they can't answer yet. Try phrases like "What's going on in your body?" or "Show me what your body needs." Even if a child looks confused at first, the act of asking plants seeds for future interoceptive awareness.
• Use "I wonder" statements. For children who experience demands as overwhelming (including those with a PDA profile), direct questions can feel like pressure. Instead, try: "I wonder what your body is telling you right now." It's curiosity without expectation of a response.
• Believe them when they share. When a child tells you something about their body, believe them, even if it's different from what you'd expect. Validation and belief are "deeply important," especially given how often neurodivergent people's experiences are dismissed.
• Model your own interoception authentically. Talk about your body sensations out loud. "My head is pounding right now and it's so loud in here. I have to put on my AirPods." This modelling shows that noticing body signals and responding to them is normal and important.
• Try modifications based on your hunches. Parents often have intuitions about their children. Test them. "Let's today try putting your food in different bowls and see what you think." If it doesn't work, you can say, "I'm so sorry, I thought maybe that would help. We could try something different tomorrow."
• Repair when you get it wrong. Nobody gets this right all the time. When you catch yourself invalidating, apologise. It's extremely validating and shows you're trying.

Kelly offers her most-used phrases: "I see this happening in your body, tell me more" and "Show me what your body needs." Simple, curious, and centred on the child's inner experience.

I wonder what your body is telling you right now.

A new way forward

The conversation between Laetitia and Kelly offers more than information. It offers permission: permission to let go of labels, to embrace not knowing, to trust that curiosity will reveal more than assumptions ever could.

For families navigating feeding differences, this shift can feel like relief. The problem was never that your child is "difficult" or that you're failing as a parent. The challenge lies in a communication gap between their body's signals and our ability to understand them. Interoception gives us a framework for bridging that gap with compassion rather than pressure.

Platforms like Understanding Zoe are designed to support exactly this kind of curious, neuroaffirming approach, helping families document observations, identify patterns, and find practical next steps without judgement.

Kelly's resources, including free videos, blogs and printables, are available at kelly-mahler.com. She also co-wrote an interactive book with her 15-year-old daughter designed to guide children and adults in noticing body signals and talking about them together. You can connect with her on Instagram @kelly_mahler.

As Kelly reminds us, the journey towards curiosity-based support is ongoing for everyone. Even experts catch themselves falling into old patterns. What matters is that we keep taking steps forward, keep believing the body, and keep showing our children that their inner experience is worthy of attention and care.