Why does my child not notice hunger, thirst, pain or needing the toilet?

The short answer

Interoception is awareness of sensations from inside the body, including hunger, fullness, thirst, temperature, pain, tiredness, breathing, heart rate and bladder or bowel signals. A child may notice a signal late, experience it intensely, find it hard to locate or be unsure what it means. Noticing, interpreting and acting are separate tasks. Use routines as external support while helping the child observe neutral details: dry mouth, tight trousers, a rumbling stomach or pressure low in the abdomen. Offer two possibilities rather than telling them what their body means. Do not assume accidents, missed meals or an unusual pain response are behavioural or sensory. Constipation, urinary problems, illness and injury still need ordinary health assessment. Seek medical advice for persistent pain, soiling, dehydration concerns, weight or eating changes, urinary symptoms, new loss of awareness or another significant change.

• Interoception concerns internal body sensations, not a guaranteed interpretation of emotions.
• Noticing a signal, understanding it and acting in time may each need different support.
• Predictable food, drink, toilet and rest opportunities can support the body without blame.
• Describe sensations neutrally and let the child correct the adult's interpretation.
• Sensory explanations must not delay assessment of constipation, pain, illness or injury.