'Interoception' refers to internal bodily processes, that sometimes enter our conscious awareness; including respiratory, cardiac, and gastric activity. Interoception is also linked to emotional regulation; maladaptive interoception can develop after traumatic life experiences, sometimes contributing to poor mental health [1]. Physical exercise and mindful body-based activities are thought to improve interoception [2]. Outdoor pursuits contain activities that can promote focus on the body; Interoceptive Awareness Opportunities (IAOs) have been incorporated into 1:1 Outdoor Education sessions at Afon Goch Children’s Homes Ltd. The IAOs are designed to be child-friendly ways to notice internal bodily sensations.

Study 1: This pilot gathered information on children’s engagement in IAOs and the feasibility of implementation. Instructors report IAOs can be naturally introduced whilst teaching an activity or skills progressions. There has been successful engagement from children, including those resistant to conventional therapy and education.

Study 2: One IAO will be tested on adults after exercising on a laboratory cycling ergometer, under two physical exertion intensities (lower and higher). Participants will be randomly allocated to an ‘interoceptive’ group, who are guided to attend to their heartbeat in their chest and elsewhere immediately after exercise; or an ‘exteroceptive’ group, who instead focus on external visual stimuli. Before and after the exercise, we will measure participants’ cardiac interoceptive accuracy through the Heartbeat Discrimination Task (HBDT), as well as cortical processing of the heartbeat through Heartbeat Evoked Potentials (HEP) [3]. Greater physical exertion and adopting an interoceptive focus are expected to lead to better HBDT and HEP scores.