Neurodiversity and interoception with Kelly Mahler, MS OTR/L
Today I got to ask Kelly Mahler (aka the QUEEN of interoception) all about the 8th sense and how our experiences of interoception differ so much across individuals, but especially within the neurodivergent community.
Kelly Mahler OTD, OTR/L
Kelly Mahler earned a Doctorate in Occupational Therapy from Misericordia University, Dallas, PA. She has been an occupational therapist for 20 years, serving adults and school-aged children. Kelly is winner of multiple awards, including the 2020 American Occupational Therapy Association Emerging and Innovative Practice Award & a Mom’s Choice Gold Medal. She is an adjunct faculty member at Elizabethtown College, Elizabethtown, PA as well as at Misericordia University, Dallas, PA. Kelly is a co-principal investigator in several research projects pertaining to topics such as interoception, self-regulation, trauma & autism.
In this episode you’ll learn:
- What interoception is
- How early interoception starts developing
- What we know (and don’t know) about interoception development in infants/early childhood
- Best ways to start when you want to start building interoception understanding in your neurodivergent child
- Episode transcript: https://www.theotbutterfly.com/72
- More from Kelly: www.kelly-mahler.com
- The OT Butterfly Instagram: https://www.instagram.com/theotbutterfly
- Work with Laura: https://www.theotbutterfly.com/parentconsult
Kelly (00:00): Yeah. Where we stand in all of this right now is that we are a model of helping someone to understand themselves. We all have such unique interceptive experiences, so what your body feels like when you’re hungry is completely the different than my experience. And so we want to empower each person to understand their own bodily sensations and what they mean for them. And then also how do you regulate your bodily sensations? It’s different with every single one of us. It’s not all going to be deep breathing. I hate to just break it down. It’s not that easy. I wish it was like when deep breathing. It’s not everyone’s game. So Speaker 2 (00:37): Welcome to the Sensory Wise Solutions podcast for parents where parents can get real actionable strategies to support kids with sensory processing disorder. I’m Laura OT and Mom To Liliana, a sensory sensitive kid who inherited my anxiety and my love for all things Disney. Consider me your new OT mom. Bestie. I know my stuff, Laura (01:01): But I also know what Speaker 2 (01:02): It’s really like in the trenches of parenting a child with sensory processing disorder. Speaker 4 (01:07): Okay, mom, enough about me. Let’s start the podcast. Laura (01:14): Hello. Hello everybody. I am so excited to bring this interview to you today. This is perfect for occupational therapy Month interception is has been gaining steam in the past decade, but for me, very recently in the past year or two, I’ve just been engrossing myself in all things interception. And this one woman’s name keeps coming up. All roads lead back to Kelly Mueller, so I had to have her on the podcast today. If you don’t know Kelly, she is an occupational therapist. Specifically, she has her doctorate in occupational therapy from Miscordia University in Dallas, Pennsylvania. She’s been in OT for 20 years, serving school-aged children and adults. And Kelly is a winner of multiple awards, including the 2020 American Occupational Therapy Association, emerging and Innovative Practice Award, and Mom’s Choice Gold Medal. She is an adjunct faculty member at Elizabethtown College in Elizabethtown, Pennsylvania, as well as Miscordia University in Dallas, Pennsylvania. (02:24)Kelly is also a co-principal investigator in several research projects pertaining to topics such as interception, self-regulation, trauma and autism, all topics that are very near and dear to this neurodiversity community. If you want to find more from Kelly, you can head to her website at Kelly mahler m a h l e r.com. All of the links for that we talk about in today’s show are in the show notes, and let’s get straight into it. Hello, Kelly. I’m so excited to have you here on the podcast. There are so many people anticipating this episode. I’ve been teasing it for a while. Everyone who’s been asking me about interception, I sing your praises and I said, and I get to interview her on my podcast. So this is a huge treat for us and my audience. Thank you for being here. I would love if you could introduce yourself a little bit about who you are personally as a parent and then also as a clinician and how you’ve found this very suitable niche topic because you’re amazing at it in the interception world. Kelly (03:25): Oh my. Well, thank you for that compliment and thanks Laura for having me on your podcast. I’m super excited to be here. I love any chance I can get talking about this topic interception because it’s very near and dear to my heart, both from a personal standpoint as well as a professional standpoint. A little bit about me personally, I am a mom of two daughters, 12 and 14 years old, so I probably need a lot more parenting and advice than many people right now because it is a whirlwind of hormones in my house right now. Oh man. Oh, we are feeling our feels talk about interception, my goodness. Laura (04:10): A whole other level of big feelings at that age. Oh, wow. Kelly (04:14): Yeah, for sure. And I’m by trade, I’m an occupational therapist. I have been an OT for over 20 years. I’ve always been super interested in topics like sensory processing or emotion regulation, mental health and learning about introception, which will I’m sure we’re going to talk a little bit more about. But introception just really marries that the areas altogether through a scientific lens. I always felt like there was something missing in my practice before learning about interception. So when I read about it, I was like, I had just was having these light bulb moments left, and I’m such a curious person. So I immediately started asking my clients and their families tons of questions, reading as much research as I could on the topic and really discovering that interception is such a big deal to all of our lives. So that’s what makes me excited to be here to talk about interception with you today. Laura (05:15): Yeah, when you talk about it’s the missing piece, I really do find that it’s the missing piece to so many of the behaviors and the challenges that we’re trying to support in our divergent kids and divergent learners. So I, I did one very quick intro post and podcast on in interception, but I would love if you gave everyone your definition of what in interception is and how really it can be linked to, I don’t want to say everything in daily life, but it really feels like it is, right? Is that over overstepping what it is? Kelly (05:51): I mean, maybe someone could find something somewhere that’s not an influence by perhaps, but I would say that your comment is very fair that interception influences so many aspects of our lives more than I ever even imagined when I first learned about the topic. Okay. So here we go. Should I do the interception 1 0 1 definition? I do. I probably say it differently every time. I know I have the same Laura (06:19): Thing with sensory processing, but I love hearing it. I want to hear your elevator speech of what interception is. Kelly (06:25): All right. Well, it’s all about a sense within our bodies that helps us to feel those bodily sensations. So whether it’s a racing heart or tense muscles or a full bladder or maybe an empty feeling in your stomach, there’s so many bodily sensations that we might notice. So interception is how our bodies come to notice those sensations and those bodily sensations are so important. They provide us with a lot of important clues, including they provide us clues about our emotions or what our body needs in that moment for regulation and comfort. So maybe our stomach is screaming, oh, I feel hungry. Or sometimes people talk about a growly feeling in their stomach and it’s because of that sensation we come to realize that maybe we’re hungry or our body needs food, or maybe it’s that we’re noticing that racing heart intense muscles. And for some of us that might be a certain clue to an emotion. For me, that means I’m feeling scared or highly nervous. So there’s this very tight connection between our body and our emotional experience. So interception informs how exactly we’re feeling in the moment, as well as it also helps us to start to learn what our body uniquely needs in that moment for comfort and regulation. So it, it’s so important for so many other reasons too, but I think that’s my elevator pitch in a nutshell. Yes. Okay. Laura (08:00): Yes, that was beautiful and I love it. Exactly it. And so now anybody hearing that, it’s probably like, okay, so that it seems pretty broad. I can imagine at every time of the day, if I really think about it, there is some internal bodily sensation that is informing me of something I need or something that I need to do with my body. So one of my questions is do we know through research, kind of the development of it? Because I heard in a recent video that you posted to your Instagram that you can start that interception obviously starts at day one zero. You already noticed those sensations. Obviously you need some level of cognition to discriminate what each sensation is and to know that this means hunger. It sounds like when you’re an infant, it’s more just comfort, discomfort, which is how you describe it, not really tuning into where or what it means, and you’re just crying. And it’s up to the caregiver to decode what that sensation is. Do we know if there’s a critical period of development or time in the brain where we can start, I don’t labeling or discriminating what each sensation really means. Kelly (09:15): We don’t have that research, at least to my knowledge. I have not seen that. We know very little about the developmental trajectory of interception. Like you said, we do know that it’s present day one of life. It’s probably developed then, which means it’s probably developing in utero. In utero, Laura (09:31): Right. Kelly (09:32): But if you think about an infant, they, most infants are born wired from minute one of life to notice comfort and discomfort within their body and respond accordingly. And at what point, I’ve even seen or talk to parents who have very young children, infants who they begin to learn different cries and what their different cries mean. And so that’s Laura (09:58): Right. Kelly (09:58): There’s no formal research, but your point question is really good at what point, yeah, I don’t think meaning pre open, pre-language, Laura (10:10): Sure. Kelly (10:11): I don’t know conceptually, I’m not anl a speech and language therapist of what happening, but it just gives me a lot of curiosity. We have so much to learn about interception, but there’s so many parents that can begin to, they begin to understand their child and know what that crime means or that grimace means, or this certain movement means for their child. And so that means their child is making different sounds or body movements to indicate a certain feeling in the body Laura (10:47): All that occur. I remember Reid, there was, I feel like it was on Oprah, some popular talk show was like, there’s these five different kinds of cries that signal tired, hungry, wet diaper. And I was like, that is fascinating. But you’re right, it probably is some of the earliest signs of our body responding to interception cues. It almost reminds me of reflexes when you’re trying to go open your mouth and, oh, the baby’s hungry. They’re ready for food. And so they’re able to indicate that in some way. So I think it must be developing in utero, but we just obviously don’t really know that as well. I’m curious. So again, I’m thinking again back. So infants, the I’m not, the zero to three is beyond my clinical scope, and so I only have one daughter, so I don’t have too much experience in the infant development world. But I’m curious if I’m thinking when they say tummy time is really good to build this and do high contrast pictures and do lots of different sounding toys and text, tactile toys, is there any activities that you of for infants or even just early toddlers that parents can do to enhance or help support building interception early on? Kelly (12:06): Yeah, I mean, this again is not an a well-researched area, so I’m going to give you our best clinical advice, but I just want parents listening or even practitioners listening to know we need to do a lot more research in this area. But right now where we’re standing is really just first of all, making sure that parents know that there is this thing called introception. I think that is 1 0 1 right there. We need to help them understand there is this sense and how important it is. So the first one is really about, as a caregiver being curious and really thinking critically about what it is your child is doing and what is that telling you about their internal experience. And we have to do that from a place of the science. There is science there that says when we assume to understand someone’s inner experience or we label their experience, we are at high risk of being wrong. (13:03)And that especially gets even more true when we have two different neurotypes, like between the parent and the child. So we have to do it this with curiosity. I see my child doing this, I wonder what it means, but avoid labeling that because we’re talking to our kids from day one of life out loud, right? Yeah. Many times. So I was raised to label my clients’ emotions, label my own, yeah. Daughter’s emotions. I say, oh, you look hungry, or you look cold, or you, you’re doing this with your body. It looks like you have to go potty. Yeah, right. But I am at risk of being wrong. That’s what the science says. So we’re really trying to shift to a place of curiosity and being like, I love wonder statements. I wonder what I see your body doing this, or, oh, I hear you crying. I wonder what’s going on. Let me see if I can help figure it out with you. So just putting that language out there, even when we’re working with pretty early learners and nurturing that curiosity, I am with you in this and I’ll try to be there with you to figure it out. Laura (14:08): Yeah, I love that it’s something that comes up, not, you said you were raised to label things. There’s still a lot of talk out there about labeling emotions, which I can see the benefit from in terms of teaching the different emotions and being, noticing facial expressions, but also you’re saying different neurotypes experience, different emotions and so many ways that if you teach them the wrong labeled emotion for what’s going on inside, then they might be misunderstood by so many cultural standards and here everything. So I could see that. So that brings me to a point that comes up a lot where I also recommend to my parents that even if your child is pre-verbal infants, we still talk to them, we talk to our dogs, they can understand us. It’s normal and social to have those interactions and connections. So I get that. But if we’re trying to teach or understand, if we’re saying I wonder statements to maybe an early learner who is maybe non-speaking yet or doesn’t quite have the cognitive abilities to label or tell you what’s going on for them, how can we best support them if we’re not wanting to assume, but they also won’t really tell us, and we’re just trying to put these clues together. (15:33)What do you suggest to parents? Kelly (15:36): Well, it comes back to that curiosity piece, and we kind of call it interception, problem solving. Again, we’re thinking about their internal experience. We know that our bodies are wired to respond if we go back to that first point that we are responding based on internal comfort or discomfort. So you have to think about that through your lens of your child and what you see on the outside, be telling you about their internal experience and then just trying different things until you meet their needs. And sometimes it’s easier to figure out what they need in that moment. And sometimes it feels like an impossible mission, right? But you’re trying things and then when you find something, maybe that seems, appears to be soothing. Again, we’re making a respectful guess here, but we could say, oh, I noticed when I dimp the lights, Laura (16:25): Oh, I almost Kelly (16:27): Not crying anymore. I wonder what that means because we don’t know. Oh, I see that you’re reaching for the bottle again. Oh, I wonder what that means. So we’re just, Laura (16:40): We’re Kelly (16:41): Being curious. I’m seeing this is happening. I wonder what that means with you and just putting and trying to get those connections out there for them. Laura (16:52): Do you think it’s fair, a middle point to not fully labeling, but still wanting for parents who are wanting to get closer to what their child’s experience is, do you think it’s fair to ask a yes or no question? I wonder what this means. Are you hungry or do you need to go to the bathroom? Can we ask our child what their experience means while we’re wondering? Give them two options if they can’t verbalize it. Because where it comes from for me is I always tell this to parents about interception. I don’t know if you know, think about it. When you go to a department store and you read the descriptions of perfumes and they’re like, there’s notes of boys and berry and this and a floral this and certain notes of the, I don’t even know what that word means. I wouldn’t even know in my head what that smells like. Same thing when they describe wine. I need someone to give me the wording for it. Is there a way that parents can do that or should do that without necessarily labeling it to help our kids form more of the way to express what they’re feeling? Kelly (17:55): Yeah, I think that’s a really good question. And honestly, we don’t know the answer to that. What we do know is what we’re hearing from so many adults that have had their experience mislabeled from early on in life, that it is extremely derailing to their interceptive experience. They begin to doubt themselves because other people are saying, well, it looks like you’re one thing, but that’s not really a match for their inner experience. So it’s extremely confusing what we don’t know. So we know that is derailing for people, but what is the right thing to do that I just even holding in your mind that you could be wrong in your assumption about what’s your child’s inner experience, I think is if you can even have that and that guides you in your interaction with your child, I think it’s better than where we were before when we were assuming that we know best. We know what’s going on with you, we’re going to label it and we’re going to teach you what we think you’re feeling like. I just feel like it’s such a shift. And I know that people listening probably tell me more about what I should be doing, but I know (19:00)I don’t think we know that. I do know that it’s really helpful to start at the body signal level rather than the emotion level. Remember, our body signals are clues to our emotion words or how are what emotion we’re experiencing. So when we’re asking someone, how are you feeling right now? What emotion? That’s a little bit too far forward in some of our kids’ lives that might not be connecting to their bodily sensations. We need to rewind and say, what are you noticing in your body? Or I see your hands doing this, I wonder how they feel. Or maybe if your child best, are your hands feeling tight or are they feeling loose? And really maybe giving them some options, but making sure that if you’re saying tight and loose, you still could be wrong. You might not be matching what their experience is, Laura (19:49): Right? So we’re always trying to find a way to make their subjective experience something more objective or concrete that we can understand from the outside. But it’s so hard because the body can’t behave and do things in ways that are not necessarily translating it appropriately. Kelly (20:07): Yeah. Laura (20:09): So the biggest daily problems that I feel like that come up in parents of young kids are things like picky eating or kids who are selective eaters and not wanting to eat certain things or not recognizing their hunger cues. And then the other thing about learning how to use the toilet and not recognizing those cues, what are your first, doesn’t have to be necessarily strategies, but areas that parents should focus on when they have already decide, they’ve already come to the conclusion, my child is not learning to eat a typical child. They’re not telling me they’re hungry or they’re saying they’re always hungry, or my child is not learning to toilet train. I was expecting they’re either always having accidents or they’re holding it. Where would they start in terms of looking into interception or what to think about? Kelly (21:02): Well, this is a really complicated area and a very important one to talk about because there’s a lot of approaches out there. I have to come at this by also saying that I have a highly picky and restrictive eater in my house. So I know the anxieties as a parent that come with that because in my, I’m undoing a lot of my thinking that it’s my primary job to make sure my child gets all the nutrients they need and they’re nourished. And it’s like, it’s just drilled into my thinking. And so I found myself so many times not affirming her experience in the world. She would say something to me, I’m not hungry. And I’d be like, you can’t possibly not be hungry. Not be Laura (21:47): Not. Yeah. It’s like, yes. So passion. See that all the time. I’m like, no, I’m starving. You have to be starving. Your experience has to be my experience or just what we know of the day, but their bodies are their bodies. But yeah, that’s hard to unlearn as a parent for sure. Kelly (22:03): So incredibly hard, and I am not dismissing how complicated these toileting and feeding are so incredibly complicated. But when you’re thinking about feeding even those hunger signals, think about what you feel your body feels like. Now, this is a respectful guest because we’re all different, but most people when they’re highly stressed, they’re digestions shuts off. Laura (22:25): It’s just a hundred percent. Yeah, they’re Kelly (22:27): Biological experience or experience for most bodies. And so many people don’t have an appetite when they’re highly dysregulated and stressed. So if we’re adding to that and saying, you can’t possibly (22:37)Be not hungry, we’re just adding on to that. I realized that with my child and that I was complicating it, but to rewind and try to validate her inner experience to help get her regulated so that she developed that internal motivation to eat, to feel hungry, to feel autonomy around food, that was the shift I had to get to. And that I’m still not perfect. I am working through this big time. And so I think also just encouraging parents to partner with someone that has a professional that has been so helpful to me. Someone that can continue to be that voice in your head saying it’s okay. And to affirm their inner experience is going to help them nutritionally in the long run. And there’s other ways we can make sure that their nutritional needs are met. Laura (23:36): Yeah, it seems like the common theme in the past few years of parenting has been our kids are telling us exactly what they need. We just need to actually listen to them, not just listen and then change it and then do something better to make them gain this skill. It’s actually, I’m literally telling you what I want. Just please honor that. And then that’s been, I don’t know about for you how long it’s been. I would say I consider myself a neurodiverse affirming therapist and parent, but it’s new for me. And it, there’s sometimes when I hear these things where I’m like, so really, what is your role as an ot if we are just not just, but listening to exactly what our kids are saying and not really shifting or manipulating it. And this is probably for any therapists who are listening now, maybe speaking to the therapist. (24:27)And so asking you clinicians to clinician how, what kinds of expectations we should be setting for parents who come to us and are like, my kid won’t eat, or My kid can’t potty train. And our best response is, let’s let them lead, or let’s listen to what they’re saying, and we don’t have this standard process of here’s what we can do to change your child to make your life more convenient, which is I feel like what a lot of parents want. So how do you navigate that as a clinician if a parent were to come and ask you about that and how you see our role as an ot? No, now as neurodiverse affirming? Kelly (25:09): Yeah. Well, I think one of the things that is to consider the interceptive experience that parents bring to the Laura (25:16): Situation, Kelly (25:18): And we’re all different as caregivers, but there could be so many different things there, underlying panic or shame or whatever it is, and really thinking critically through that and how do we support that caregiver in the way that they need intercept really supported. But also, I do love to partner with affirming dieticians so that they have that expertise because I think a lot of times, at least a lot of the caregivers that I am partnering with is that they have a lot of mean, their primary question is, how do I make sure my child is well-nourished? Right? Laura (25:58): Sure. Yeah, exactly. Kelly (26:00): Or are they ever going to be potty trained? Right. And so for the feeding, I like to make sure we have someone on board that really is trained and understands that nutrition piece and helps them, their child to have other ways that does seem to reduce the anxiety around, like you were saying, we must change my child so that they eat so that they’re healthy, so that they’re going to live a productive life. Laura (26:24): And then I can turn off and be like, cool, I did it and sit back. So part of it is about the parent. Kelly (26:29): A huge part of it is actually about the parent and how do we make mealtime super regulating and fun and we reduce the demands on the parent as well as the child, because if that parent’s feeling more regulated then, and so many of our kids are so attuned to their parents and they’re feeling those vibes from their parents in such big ways. So I think it can make mealtime, there’s so many things and what does mealtime look like? Laura (27:00): That’s another different Kelly (27:01): Questions we need. Maybe it’s pacing around the table is what mealtime looks like for your family, and that’s okay. Yeah, you don’t have to sit in a chair to be, there’s so many things, things where we can acknowledge and validate that child’s experience and what they need in their body to feel safe to participate in daily activities like feeding. Laura (27:23): Yeah. I want to know, would you say that, are there way are ways to build interception skills in terms of the way that our body processes and improve that? Or is it more about focusing on increasing awareness and just what they mean? Not necessarily how my body responds to it. Because I know when we talk about kids who are very emotionally reactive, sometimes we think about they’re more reacting to the internal sensations rather than, he took my block. It’s not that it made my chest tighten, and they are responding in a hypersensitive way to those internal sensations. Do we think about improving modulating that for helping their modulation and how they respond to those cues? Or do we focus more on how can we build their awareness of what those cues mean and not necessarily rewiring or tolerating more or any of that? Kelly (28:22): Where we stand in all of this right now is that we are a model of helping someone to understand themselves. We all have such unique interceptive experiences, so what your body feels like when you’re hungry is completely the different than my experience. And so we want to empower each person to understand their own bodily sensations and what they mean for them, and then also how do you regulate your bodily sensations? Yeah, it’s different for every single one of us. It’s not all going to be deep breathing. I hate to just break it down. Yeah, it’s not that easy. I wish it was like, but deep breathing is not everyone’s game. So it really is just helping each person to notice their bodily sensations, understand what they mean, and then how do I regulate my bodily sensations unique to my experience. Laura (29:12): Yeah. So I want to talk more about then that, because I know you have a activity book, strategy book for building interception awareness and how to probably make these detective work set interception detective work more fun and through playful games with kids. How does this look, if you could give us an example of how caregivers can do this with most of my audience, I would say is early childhood, early years towards that kind of stage. What does some of this look like if parents were trying to help build awareness, understand what their body is doing, and also how to explore, what regulates that? How does that look for you? Kelly (29:55): Yeah. Well, I think maybe you’re referring to the interception curriculum, which is one of our most, yes. Yeah. All right. That’s one of our most popular resources. And so it’s divided, the interception curriculum is divided into three sections. So the first one is called body, and it’s all fun things to help someone notice their body signals. Then we have section two is emotion, and that gets at helping each person to connect the body signals that’re noticing to the emotion, the meaning for them. And then the final section is action, and those are all the actions that they can discover to help regulate all those different, so Laura (30:31): You highlight it all in the book. That’s beautiful. I’m definitely going to put a link for that in the parents. And would you say this is appropriate for all caregivers, educators, clinicians, whatever level you’re at? Kelly (30:41): So we wrote this specifically for professionals to be using with, but there are a lot of caregivers out there using it because we don’t have anything else for Laura (30:52): Anything else, Kelly (30:52): Caregivers. But we are writing a book for the parents and caregivers because Okay, I am a realistic parent myself and the putting a curriculum in place in my family’s schedule is I have respect for these families that are doing the curriculum, doing their the work. Yeah, they’re doing the work for sure. But just some easy things that kind of a spin from the section one of the interception curriculum. One of my favorite strategies in there is something called focus area experiments, and it’s where we pick one body part. So we chunk the work into one body part at a time, and we invite learner to notice how that one body part is feeling during fun activities. So I think about what are activities that could possibly evoke a stronger feeling in that body part to help capture attention, give practice noticing. So it could be something like playing with slime or splashing in water, or when you’re washing your hands or when you’re getting a bath or you’re putting hand sanitizer on, or you’re hanging from playground equipment. (31:54)All of those times, we can’t guarantee it’s evoking a stronger feeling in that child’s hand, but it most likely could be. And those are great times to nurture that curiosity, be like, oh, I wonder how your hands are feeling right now while your hands are under this water. I wonder how your hands are feeling when you’re hanging from that bar right now. And so we try to find these everyday focus area experiments. We try that we call them times in the daily routine that could be evoking a stronger feeling in that body part that we’re working on currently. And then inviting that attention. We also have a lot of language and visual and communication supports. We’re doing this even with non, a lot of non-speaking clients. And so we have little menus of words you can use to describe what you might be noticing whenever possible. We want it to be their own word, but sometimes just we need that little bridge of language or to get that child really that bridge to get them to be describing. But really the first and foremost is just noticing, giving them lots of practice to notice how their body is coming when they’re regulated. Yeah, when they’re playing, when they’re feeling good in their body, because who wants to notice how your body feels when it’s dysregulated? Yeah. Right. Laura (33:16): Yeah, I imagine. So the examples you gave, I know there just one of the examples was hands underwater and slime, which I know obviously is integrated with the tactile sense, but it’s also external. You can visually see it. Where I find the hardest time for some clients, especially when we’re like, where do you feel the pain? Is it in your head? Is it a sharp pain? Is it a dull pain? Is it in your tummy? Is it on the left? Is it on the right? All of those internal things that they can’t even see what looks like. Yeah. Are there activities for that to draw awareness into a certain part of the body that they might not even their internal organs that they don’t even know? Yeah. I don’t know if I’m extra explaining the question, but something internal feels like, Kelly (33:59): Yeah, it’s a good question. In the interception curriculum, we start with outside body parts first, and we work on noticing how do your hands intercept feel or how do your feet intercept feel? So the tactile piece would be, in my mind, how does that slime feel? What is the tactile quality of that slime? But bringing it to an embodied experience would be how do your hands feel while you’re holding this line? So that brings it to the body and noticing how your body feels. And then we slowly work our way in to the inside body parts. How does your heart feel? How do your lungs feel, how stomach feel? But we’re still using lots of focus area experiments to try to evoke a stronger sensation. We might run around really fast or do a fast dance and then notice how our heart feels, yes, for our lungs. Or we might lay on a yoga ball and notice how our stomach feels while we’re doing that. So just doing things that we’re trying to evoke or change the way that body part feels to help capture that attention. Laura (34:59): And then when you’re exploring regulation tools, then you have them do that regulation tool and then see how that draw their awareness to how that maybe manipulates their heart rate or how they’re now, after we do this activity, do you still feel that in your tummy? Is that kind of how you link the sensory tool or the body-based tool to the interceptive piece? Kelly (35:22): Eventually, as they begin to really understand their body better and they move through the curriculum, when we get to the final part, which is all the action, then they’re better equipped because they understand their bodies better to identify, try different activities and identify how does this make my body feel? I really like this brings my heart rate down, or this makes my muscles feel loose, or this hurts my lungs. So they’re really equipped to be like, yes, that is a helpful regulation strategy for me. And no, that is not where before I knew about interception, I was throwing tons of regulation and coping skills out there and being like, oh, try this. And they were just memorizing. It was me telling them almost what to do, which I didn’t realize at the time I was trying to be helpful. And now we’re more empowering. You make the decision because we, they discovered that and they have that body information now to make those connections for themselves. Laura (36:29): So really our biggest work as clinicians and parents and educators and teachers is to really, really hone in on teaching our kids about their body and their brain. So when we still would offer strategies and breathing things and techniques for them to try, but we want them to be able to know their body and brain enough and the fluctuation and regulation to know, this made me feel more this way or this way. And then we can take that off the list and say, okay, well, we’re not going to do that breathing again. Right? Totally. Yeah. Yeah. So that’s an area of focus that I think we need to bring parents more towards because we’re always like, how do we fix this? What can we do for my child to get them better at this? And the answer is always just help translate what they’re experiencing and tell them or not tell them. Work with them to help understand, translate what that is meaning for them. Right. Kelly (37:22): Absolutely. And I bet that there are many parents, if they really think about their child, their child might already be naturally connecting to some really powerful regulation strategies for them. And sometimes we’re getting so much better at this, but sometimes those regulation strategies were behavior wise, they were nor tried to be normalized. So if your child is lining up toys and they are in it and they’re so regulated doing it, yay, you now know a powerful regulation strategy for them. Or if they’re like they’re pacing or they’re flapping or they’re humming. There’s so many things that our kids, many times naturally connect to that promote comfortable, interceptive feelings in their body. But in the past, we did everything we could to eliminate those and then wondered why self injurious behavior would emerge or yeah, it was another attempt. It was their desperate attempt at regulating had other things taken away from them. So see those things as a amazing part of your child, they are intercept listening to your body, to their body. I’m sorry. And celebrate that. Yeah. I think it’s so important. Laura (38:42): I’m curious. So my daughter is, I would say very hyper aware of her interception cues. She all day long, my toe is buzzing. Oh, it went away. She’ll report, my knee feels a little creaky. And she said the other day, my heart feels cold when I breathe this. And I was like, oh. And I don’t know, do I just leave that and say, thank you for sharing with me, or should I take those opportunities and dig deeper? What do you think that means? Or what do you do if you notice what should parents do? But when they notice our kids are volunteering these descriptions of their body parts so that we can keep that as part of our conversation, how would you tell a parent to respond to those things? Kelly (39:28): Yeah. I think it really depends on the child, but for it definitely always you want to validate that in some way that your child is going to respond well to. So whether that’s like, yeah, that is incredible that you’re noticing that. Thank you so much for sharing. When Laura (39:44): She said, my heart feels cold, I was like, what do you mean by that? Kelly (39:47): Yeah, Laura (39:48): I thought she was watching too much Elsa, the frozen thing. But she goes, no, when I breathe really, really deep, I can feel my heart getting cold. I’m like, oh, you must be getting air to your lungs. But again, I don’t want to label it. I just wanted to join the conversation with her and engage a little bit. Kelly (40:05): Yes, because if you keep that dialogue open, the chances are of her share, continuing to share those insights with you, it’s pretty high. Then the minute we shut it down, the minute we try to correct them and say, there’s no possible way your heart can feel cold. She might not share with you again. Yeah, Laura (40:24): That’s right. And Kelly (40:24): Some kids need reassurance. Why is my toe buzzing? Yeah. So maybe that’s your child then. That’s awesome. You’re noticing that. Let’s figure out what that means for you together. Yeah. So it really depends on the child and what they need, but those body signals are really important. And if they’re a little anxious over them, we can normalize it. Talk out loud what your body is feeling around her so she knows it’s happening for you too. Laura (40:51): Yes. Kelly (40:53): It really depends on the child. Laura (40:55): Cause they do feel like sometimes parents will, if their kids are anxious about it, oh, just don’t think about it. That’s the worst. As an anxious person, that is the worst thing to tell me is to not think about something. So yeah, it never works. It never works. Kelly (41:11): No, and I did that to my kids. They would fall when they were little and they would help a scrape on their knee and was, from my anxiety, I’d be like, oh, you’re fine. You’re totally fine. Big deal. And I’m like, whoa. That’s gaslighting their perspective, experience. They’re crying, they’re feeling something, and I’m like, oh, it’s fine. It’s no big deal. Yeah. No, it’s so hard. I’m constantly questioning myself as a, Laura (41:34): It’s good to hear that even professionals who have been in this game for such a long time still have those thoughts. I want to ask another question before we sign off. Is for a lot of these, for divergent learners and divergent kids who we are working on building their understanding and awareness of interception, that’s like a long journey. It’s something that we’re continuously helping them. What are some of your favorite ways in the moments when they’re still struggling, some of your favorite accommodations for interception challenges? Something that I’m always telling parents while we’re building, we’re building their fine motor skills. Here’s an accommodation for their paper to help their sizing, and eventually we’ll wean them off. Or we’re building this vestibular processing skill. Well, n right now, they don’t have that. Here’s an accommodation. The chair is going to support their posture so that they can focus on school. What are some of your favorite go-to accommodations for kids who don’t have that awareness yet for interception? Kelly (42:32): Yeah. We call these adaptations for ia, and it’s really just thinking about, I wrote a book on this with two autistic adults, and then we just call it, how can you outsmart or hack your Interest? Oh, I love that. Yeah. So really, again, I It’s really hard to give a blanket. Yeah. One, Laura (42:56): What if we focused on one specific, if we thought of one child, just so we could think, see of how you think of it for a CH sleep. Sure. Kelly (43:05): Yeah. Okay. So that’s the one that was coming to my mind. Yeah. Cause there’s so many of my clients are like, I’m not sleepy right now. And then they obviously go way past Laura (43:14): The wait overtired Kelly (43:16): Sleep window, and then they’re so dysregulated and whenever possible, this isn’t always possible with all of my clients, whether it’s age or cognition, but really working collaboratively together with them if possible and being like, Hey, we’re going to do, we’re try X, Y, and Z and see if this works for you. You have full autonomy. I usually try to convince them to try it three times and then if they don’t, unless they’re super, no way, I’m not doing that. Sure, they always have an out. But just doing things, setting a timer to start a certain bedtime routine, developing that bedtime routine. So it’s signaling to yourself that it’s time for bed because you’re not getting those reliable clues from your body letting, hey, now is a time, an ideal time to go to bed. So we’re going to set some hacks using your cell phone or some kind of technology, doing a routine that’s really kind of setting the stage for you to go to bed. Just little things like that. There’s so many apps out there, even for kids that might not be noticing thirst signals, like Laura (44:23): That was one that coming to mind. That was one that was coming to mind for me. For kids who won’t drink water. Kelly (44:28): Yes, there’s so many cool things out there, electronic or smart water bottles that send you little messages to drink or those little potty watches that vibrate to remind you to just go and try to use the bathroom. So there’s a lot of little different hacks out there that you can try. Yeah. Laura (44:44): So are, I dunno what the word I’m thinking of fair or to use, even though it feels like it’s externalizing the, even though I might not actually be thirsty, but because I can’t accurately tell I need to hydrate, so I’m going to do it because this timer is telling me to, and that’s okay. That’s not going to confuse or derail our interception processing. Kelly (45:11): Yeah, I think as long as it’s a match for what that person is meaningful to that person, we’re not forcing these adaptations on them. I think that it’s okay. We want to think about developing that. Those body signals, they’re noticing and connecting and regulating their body signals. But I have a lot of divergent friends who are very successful, who have a lot of hacks in place that they might not be telling you about them. I have a friend who goes to the bathroom every two hours unless she has coffee that day, then she goes to the bathroom every one hour until lunchtime. So she’s going to the bathroom based on a rule she’s created for herself, not based on the way her body feels. And I mean, she is highly successful, thriving adult who has this hack in place that has really helped her and kept her healthy and successful. So all that being said, I think it’s not a one size fits all answer. I think it’s meaningful to that person, Laura (46:11): And I think that’s a wonderful example and things that I’m always telling parents where you’re fast forwarding, is my child always never going to be able to potty train or drink or eat this? And it’s that idea that they will, if we give them the translation, the blueprint to their brain and their body and we translate that, then we are setting them up for success so that they can create the lifestyle that works for their needs. So we don’t always have to be the parent that says, you should be doing this today, you should be doing this. And we can take our hands off as best as we can depending on the individual. But if you’re in the thick of having a hard time with meals or toileting and you’re seeing your kid in college still not eating or using the bathroom, I think instead of focusing on trying to rush those particular surface level skills right now, we think big picture and think of your job. (47:06)It’s okay, maybe I need to work harder at helping them understand the way their body feels. And that is the long game that I think will serve neurodivergent individuals across their lifespan that I want to focus my daughter on. Knowing that where I start worrying, I’m like, well, at least she knows her body and what it needs. I know I’ve taught her that she can ask for this. I know I’ve taught her that if this isn’t available, she can always do this with or without my help. That’s like the thing that lets me sleep at night is something that that’s what I can focus on. Kelly (47:35): Yeah, I love that. Yeah. Laura (47:37): Okay. So Kelly, can you let everybody know all of the ways that they can learn more from you, all of your services, your books, or the best place to find you when they want to connect with you after this and learn more Kelly (47:50): And you can really learn most of what you might want to learn about interception on my website, it’s kelly-mahler.com. We have tons of free resources on there, videos, blogs, articles. So if you want to learn more, it might be a good place to start. And then we have all of our paid resources on there too, our books and our courses and everything. Laura (48:11): I’ll put a link to that interception curriculum that you mentioned for therapists and potentially some caregivers. But I have binged a lot of your YouTube videos. So if you’re a YouTube person or even I’ll put it on and not watch, but listen kind of as a podcast while I’m getting ready, I’ll, your YouTube content stuff is really, really good too and free. So everybody should check that out. So thank you so much for being with us today, Kelly. I learned a lot. I hope everyone listening learned a lot, and I will definitely be checking out your resources after our call. Kelly (48:45): All right, thanks, Laura. Speaker 2 (48:50): If you enjoyed this podcast, please consider rating it and leaving a review, which helps other parents find me as well. Want to learn more from me. I share tons more over on Instagram at the OT Butterfly. See you next time.