Interoception and pediatric occupational therapy practice: a protocol for a scoping review

Clark, Emma; Yu, Mong-Lin; Brown, Ted

doi:10.1590/2526-8910.ctoAO28633721

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Sumário

Original Article • Cad. Bras. Ter. Ocup. 32 • 2024 • https://doi.org/10.1590/2526-8910.ctoAO28633721 copy

Interoception and pediatric occupational therapy practice: a protocol for a scoping review

Interocepção e prática da terapia ocupacional pediátrica: um protocolo para uma revisão de escopo

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction

Interoception is relatively new within pediatric occupational therapy practice. Interoception allows us to feel and interpret internal body sensations and is related to our ability to regulate emotions and behavior. It is associated with other functions including sensory processing, self-regulation and executive functioning, making it important for everyday participation in life activities. Pediatric occupational therapists are considering interoception as part of intervention but there is limited research to understand how and why occupational therapists use interoception in clinical practice.

Objectives

The aim of this protocol is to describe the methodology and analyses to be used to undertake a scoping review.

Method

This paper presents the protocol for a scoping review. A search of literature from ten electronic databases (Ovid Medline, Ovid Embase, Ovid PsycINFO, ERIC, Scopus, CINAHL, ProQuest Dissertations & Theses Global, AMED, OTDBASE and Google Scholar), grey literature and article reference searching was conducted. Title and abstract screening was completed before full-text review. Selected articles met stringent inclusion criteria. The PRISMA-ScR Checklist was used alongside the Crowe Critical Appraisal Tool to ensure robust data extraction and synthesis from selected studies.

Results

A total of 2449 articles were retrieved. Eighteen articles were included in the review. A narrative synthesis approach will be used to synthesise data.

Conclusion

Findings from this scoping review will inform future research related to interoception and pediatric occupational therapy practice to support clinicians to consider evidence to underpin practice.

Keywords:
Occupational Therapy; Children; Review Literature as Topic

Inclusion criteria	Exclusion criteria	Justification for consideration within the scoping review
Published in English	Not published in English	Consistent terminology and understanding of interoception was pertinent to the aim of understanding how interoception is used in pediatric occupational therapy. Studies published in the English language were included to avoid translation challenges and cultural confusion.
Published since 2013	Published before 2013	Interoception consideration in pediatric occupational therapy is relatively new; therefore, only sources within a ten-year period were selected to ensure information remained current.
Specifically discussing child populations, included child populations alongside adults, or focused on occupations relevant across childhood	• Specifically focusing on adult populations	A pediatric lens has been set for the scoping review. The review considered literature pertaining to children and pediatrics within an age range of 0-18 years. Some of the literature included had a lifespan consideration rather than a sole childhood focus or did not define a specific age group; however, studies of this nature were still included if the focus could be applicable to occupational performance for children.
Must focus on interoception and/or its related factors	Does not specifically focus on interoception and its related factors;	Literature must focus on interoception and related concepts rather than other related topics. Literature pertaining to mindfulness was excluded. While inherently linked (Gibson, 2019 Gibson, K. (2019). Mindfulness, interoception, and the body: A contemporary perspective.Frontiers in Psychology, 10. https://doi.org/10.3389/fpsyg.2019.02012 . https://doi.org/10.3389/fpsyg.2019.02012... ), mindfulness theory and intervention focus more on stress reduction and being present in the moment. There is an element of body awareness (which links with interoception) but the overarching goal is to learn to accept the present, which often means focusing on unwanted experiences to learn to accept them. Interoception treatment on the other hand, focuses on body signals and teaches attention to be directed to inside the body to develop awareness of emotional states. It is this link to self-regulation (Cheung et al., 2023Cheung, H. Y. L., Brown, T., Yu, M.-L., & Cheung, P. P. P. (2023). The relationship between school-age children's self-reported perceptions of their interoceptive awareness and emotional regulation: an exploratory study. Journal of Occupational Therapy, Schools & Early Intervention, 1-27.) and executive functioning (Bishop et al., 2023Bishop, C., Brown, T., & Yu, M.-L. (2023). The relationship between school-age children’s interoceptive awareness and executive functioning: an exploratory study. British Journal of Occupational Therapy, 86(2), 116-129.) which is distinguishable and ultimately used more exclusively within occupational therapy and therefore the reason why mindfulness literature was excluded.
Must focus on interoception and/or its related factors	Mindfulness focus
Specifically related to the scope of pediatric occupational therapy clinical practice; including but not limited to, goal setting, assessment/information gathering, intervention provision, theory or concepts informing and underpinning clinical practice	• Medical or nursing (including pregnancy and antenatal) or other allied health or education disciplines involved;	Occupational therapy practice was the focus of the scoping review, despite interoception-based practices being used across other allied health and education professions (Goodall, 2021Goodall, E. (2021). Facilitating interoceptive awareness as a self-management and self-regulation tool to increase engagement in learning and education. University of Southern Queensland.; Price & Hooven, 2018Price, C. J., & Hooven, C. (2018). Interoceptive awareness skills for emotion regulation: theory and approach of mindful awareness in Body-Oriented Therapy (MABT). Frontiers in Psychology, 9, 798-798.). Studies were then included if they considered a broader multidisciplinary approach in addition to occupational therapy and/or could be considered by occupational therapists as part of evidence-based practice inform their practice. Such studies were deemed relevant if the scope of the paper presented information relation to the use of assessment or intervention in a multi- or trans-disciplinary approach. Occupational therapists work may have a wide scope of practice pertinent to their role in any clinical setting so it was important to capture literature that could be applicable to differing practices. Medical-based studies (including medicine, nursing and imaging) were excluded as aims were related to diagnostic or biological/anatomical information. Parenting-related sources were considered outside the scope of this review as outcomes were not occupation-focused.
	Provides an anatomical, physiological, or biological understanding of interoception (including imaging);
	• Parenting programs or general parent advice
Must be linked to considering and/or improving client outcomes of occupational performance or participation	• Omitting client outcomes or occupational performance and participation because of interoception	Crucial to occupational therapy practice is outcomes of occupational performance and participation; therefore, studies needed to address occupational outcomes for clients.
Articles published in non-predatory journals;	• Articles published in journals considered to be predatory	Peer-reviewed journals present high quality and rigorous research where information can be trusted; therefore journals considered to be predatory were omitted to ensure rigor. Grey literature has been included and Determined by not being on the following database: https://beallslist.net/standalone-journals/).
Grey literature relevant to pediatric occupational therapy practice	• Articles published in journals considered to be predatory

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[1] All authors approved the final version of the text.