Building Brains That Feel: How Occupational Therapy Supports Emotional Awareness in Children

When we think of occupational therapy, we often picture fine motor activities, sensory swings, or handwriting support. But there’s a quieter, equally powerful part of the work we do: helping children build emotional awareness: the ability to notice, name, and respond to what they’re feeling.

In today’s world, where stress, overstimulation, and performance pressures touch children earlier than ever, growing a brain that can feel safely and confidently is just as important as one that can think and do.

This is where occupational therapy steps in.

What Is Emotional Awareness?

Emotional awareness is the foundation of emotional intelligence. It means being able to:

• Recognise what you’re feeling in your body

• Name the emotion (e.g., “I’m feeling angry” or “I’m nervous but I don’t know why”)

• Understand what triggered it

• Choose what to do with it

Children are not born with these skills, they are built over time, and often, they need extra scaffolding when development is affected by neurodivergence, trauma, sensory processing challenges, or early disruptions in co-regulation.

The OT Approach: Emotions Live in the Body First

Occupational therapists understand that feelings show up first as physical sensations.

A tight chest. Wobbly knees. A racing heart. Butterflies in the tummy. Shaky hands. These are often the first signs a child feels something, but without interoceptive awareness (the sense of what’s happening inside the body), they may not know what the feeling is, or what to do with it.

So, before we ask children to name their emotions, we help them notice them.

This is where body-based regulation work, sensory integration, and interoception support come in.

Tools We Use in OT to Build Emotional Awareness

1. Interoception Mapping

We help kids learn to recognise body signals for feelings like hunger, stress, anxiety, or excitement. This might involve body maps, mirror play, or guided discussions like:"When your heart beats fast, what might your body be telling you?"

2. Movement and Breath

We use rhythmic movement, stretching, and breath work to build self-regulation and connect children to their emotional state.Why it matters: Regulating the nervous system gives children access to their thinking brain.

3. Sensory Ladders and Zones

Children learn to identify how they’re feeling using visual scales like the “Zones of Regulation” or custom sensory ladders. These tools give language and structure to what can otherwise feel chaotic.

4. Co-regulation Rituals

OTs coach caregivers to use attuned, sensory-informed strategies for co-regulating with their child because kids learn to self-regulate through relationships, not before them.

5. Emotion-Rich Play

We embed emotional exploration in play: pretending, storytelling, role play, or even creating characters with different “feeling powers.” This supports not just expression, but empathy and perspective-taking.

When Emotional Awareness Is Difficult

Children may struggle with emotional awareness for many reasons:

• Sensory sensitivities that overwhelm the nervous system

• Language delays or processing difficulties

• Neurodivergent wiring (autism, ADHD)

• Past trauma that has made emotions feel unsafe

• Difficulty shifting attention to internal states

OTs help uncover the root of the difficulty and offer tools that feel developmentally appropriate and safe.

The Outcome: Children Who Feel Safer in Their Bodies

When children build emotional awareness, they:

• Understand themselves better

• Communicate their needs more clearly

• Cope with frustration, fear, and change more effectively

• Build stronger, more connected relationships

And most importantly: they learn that all feelings are okay and that there are ways to move through them.

Final Thoughts

In OT, we’re not just building stronger bodies or sharper skills, we’re building brains that feel, notice, and understand.

Emotional awareness is not a soft skill. It’s a survival skill. And with the right support, every child can learn to listen to their body, name their feelings, and live more peacefully in their skin.

Because emotional literacy isn’t just about naming the feeling, it’s about giving children the power to choose what to do with it.