Paediatric occupational therapists' views on applying interoception in practice contexts

Interoception, the ability to notice, understand, and act on internal bodily signals, is increasingly recognised as relevant to children's self-regulation and participation. While a growing body of research has examined interoception-based assessments and interventions with children across health disciplines, less is known about how these concepts are being interpreted and applied within paediatric occupational therapy practice. Understanding current clinical reasoning and practice use is important to support evidence-informed occupational therapy intervention in this emerging area.

Qualitative semi-structured online interviews were conducted with 22 Australian paediatric occupational therapists. Reflexive thematic analysis was applied, ensuring credibility, transferability, dependability, and confirmability.

No consumer or community involvement.

Four main themes were identified: (1) 'Learning as we go': What occupational therapists know (and do not know) about interoception, (2) Integrating interoception into practice, (3) An empty toolbox: We need more tools, and (4) Context matters: Environmental influences on interoception in practice. Three sub-themes were identified for the second primary theme. These were titled (2.1) Using theory to guide practice: How occupational therapists think about interoception, (2.2) Setting the interoception scene, and (2.3) A bridge to participation.

Paediatric occupational therapists value interoception as foundational to children's regulation and participation; however, knowledge and confidence remain variable, with many therapists describing an ongoing, practice-based learning process. Interoception is applied across the occupational therapy process and shaped by professional reasoning, experience, and contextual factors, yet limited occupation-focused tools and guidance constrain consistent implementation. These findings highlight the need for occupation-based assessments, structured resources, and targeted professional development to support evidence-informed practice.