A quarterly publication of the Autism Research Institute

The Autism Research Review International is quarterly publication of the Autism Research Institute

Winter, 2022 | Number 1, Volume 36

Impairments in interoception seen in children with ASD

Researchers in China report that children with autism spectrum disorders (ASD) exhibit impairments in interoception, which is the ability to process and integrate internal signals such as heartbeat and breathing patterns. 

Han-xue Yang and colleagues evaluated 30 children with ASD, 20 children with comorbid ASD and attention-deficit/ hyperactivity disorders (ADHD), and 63 neurotypical controls, using an eye-tracking interoceptive accuracy test (EIAT). The neurotypical controls were further divided into those with and without elevated levels of autism traits. 

The EIAT shows two bouncing rabbits on a screen, and participants are asked to look at the shape that is bouncing in synchrony with their heartbeats. An eye tracker captures their eye movements, while a pulse oximeter measures their heart rates in real time. 

The researchers report that autistic children either with or without ADHD exhibited lower interoceptive accuracy on the EIAT than neurotypical controls. In addition, neurotypical children with elevated levels of autistic traits had poorer interoceptive accuracy than neurotypical children with lower levels of autistic traits. Contrary to the researchers’ expectations, children with ASD and comorbid ADHD did not have lower interoceptive accuracy than children with ASD alone. 

The researchers conclude, “Difficulties in sensing and comprehending internal bodily signals in childhood may be related to both ASD and ADHD symptoms.” However, they note that their sample size was small and that their focus was limited to cardiac interoception, which is only one aspect of interoception.


“Decreased interoceptive accuracy in children with autism spectrum disorder and with comorbid attention-deficit/hyperactivity disorder,” Han-xue Yang, Han-yu Zhou, Ying Li, Yong-hua Cui, Yang Xiang, Rong-man Yuan, Simon S. Y. Lui, and Raymond C. K. Chan, Autism Research, January 27, 2022 (online). Address: Raymond C. K. Chan, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Beijing 100101, China, [email protected].