What is Insight in Childhood?
Insight in childhood is the ability to understand who you are personally, emotionally, and in relationships.
If insight is a concern with a child, you will notice they struggle to describe emotions and discuss personal experiences.
A child or teen may seem to overreact to distressing events and be unable to explain these reactions to others. They may be hard to read emotionally.
You may see your child has an easier time with fact-based questions and has a more challenging time talking about personal information or relationships.
Top 10 Symptoms of Lack of Insight in Children
- Unable to comment on their emotions: your child is unaware of how they are feeling and tends to always answer ‘I don’t know’ to feelings questions
- Unconcerned about the world around them: your child prefers their own imaginative world and struggles to have insight into another’s world or perspective
- Unsure what to say: your child wants to connect with peers but does not have the skills to know how to meet new people, find connections and build on those relationships
- Unable to articulate a feasible long-term goal: your child is not able to imagine their future or communicate a realistic long-term goal (e.g., a teenager who has not joined the swim team but shares the goal of being an Olympic swimmer)
- Confused by open-ended questions: your child does not know how to converse about abstract or relationship questions
- Missing a best friend: your child is lacking in awareness of how to form deep and lasting friendships
- Struggles to articulate likes and dislikes: your child may answer “I don’t know” when asked about their favorite animal, color, or vacation spot
- Lacking emotional language: your child is unsure what to say about their emotions. When you ask, “How do you feel most of the time?” you hear, “I don’t know” or “Bored.” Your child may have a ‘flat’ facial expression regardless of the emotional charge of a situation. You may find yourself saying, “that kid could win the lottery, and he wouldn’t crack a smile”
- Difficulty reading emotional cues: your child may have trouble reading other people’s cues, emotions, and interests. When asking your child about feelings, you might hear, “I don’t like talking about emotions,” “I can’t describe my feelings,” or “I don’t like all these questions”
- Irresponsible and immature: your child may not realize that to obtain certain goals, there are particular behaviors required on their part. You may find yourself saying, “my child is not responsible,” or “they don’t have personal goals,” or “she is so smart, but she just won’t apply herself”
What poor insight looks like in children
Example 1: One clinician asked a child about his future, and he said, “I’d live in the Australian Outback by myself (he was 8). I’d have a big truck, and I’d shoot you if you came there.” He said, “Marriage? It’s to perpetuate the human species. I don’t want to do it.” When asked about feelings, he said, “I don’t know. I’m just bored.” He denied experiencing any other emotions.
This child was very matter-of-fact and polite. However, he wanted to be alone, and he did not think about his feelings or have insight into himself.
He was not unhappy, but he was a bit disconnected. His fantasy turned out to be related to a TV show he liked about the Outback.
He needed support to develop who he was, personally and emotionally.
Example 2: An adolescent who explained that he was depressed last year.
When asked about his emotions, he shared that he does not feel any. He said that his parents told him he was depressed. He noticed that he sometimes had a very blank feeling that other people called “depression.”
He said, “we’ve been working on it,” referring to his family.
He could not describe any emotion, but he did note that he was not depressed any longer.
He was not able to articulate why or how he knew. His facial expression was limited in range, and he used little nonverbal communication.
He had experienced a successful school year with good grades and developed two friendships. He was 18 and with an overall IQ score in the Very Superior range and 99.9th percentile.
Clinicians get concerned when we see a child with a high IQ who cannot talk openly about simple emotions or elaborate on emotional experiences during a conversation.
He needed regular therapy to work on his insight and to continue to develop reciprocal relationships.
Example 3: An adolescent girl presented with an above-average ability and a strong vocabulary.
She stared blankly at the examiner when asked, “what do you do for fun?” After a long pause with no exchange, the examiner followed up with “maybe some favorite games or books?” The teenager said, “both of those.”
When asked, “what will you do on vacation next week?” she stared blankly again. When the examiner confirmed, “aren’t you going on vacation?” she said, “yes.” When asked about her friends, she said, “They are wonderful,” but could not name any of them or what they like to do together.
This teenager was intelligent, kind, compliant, and really struggling to answer these questions. Yet, she had no idea how she was doing in life, how she felt, or what her strengths were as a person.
Causes of Lack of Insight in Childhood
Personal and emotional insight and personal responsibility can be subtle challenges that may fly under the radar without other symptoms.
High functioning autism: often, bright children who are compliant and successful in school are not identified as having challenges until the teenage years. These challenges can pose a serious problem in identity development.
Child development expert, Erik Erikson, defined the ‘Stages of Identity Development’ several decades ago. These concepts are still foundational in child psychology.
During identity development, children, teenagers, and adults view themselves through a social-emotional lens and discover their strengths and weaknesses. This process is an important component of building self-esteem in the childhood years and developing a sense of identity in the teen years, which leads to meaningful relationships in the early adult years.
In Erikson’s theory, children develop interests, independence, and responsibility as part of coming to their own identity. Some children and adolescents, particularly those with autism, need support in this process and guidance in discovering interests, strengths, and how we relate to other people.
The companion to a lack of personal and emotional insight is challenged with perspective-taking or understanding this information about others. See the companion article to this one on perspective-taking.
Autism Spectrum Disorder is about social communication. This disorder includes social challenges and restricted and repetitive behavior patterns or interests.
Social communication difficulties in autism often include difficulty knowing what to say, carrying on back-and-forth conversations, and reciprocity.
Individuals with ASD may struggle to know how to contribute meaningfully to a conversation or interaction. In addition, they may not have the insight into their strengths and weaknesses to assess their contribution.
When teenagers do not know how they feel, this challenge can limit their ability to converse and connect meaningfully with peers.
Neurological causes of insight problems in autism
Autism is a disorder of connectivity [1,2]. This phrase means that parts of the brain do not always make fluid connections to other parts of the brain, and social and emotional memories are not always properly categorized or stored.
A child with an Autism Spectrum Disorder may recall with detail an event that happened four years earlier. They may have strong emotions regarding that one memory but may not be able to tell you what happened yesterday at school.
Memories are stored in the neuro-network: People with autism are not developing a strongly connected framework. The typical brain stores emotional memories with information like “That was embarrassing, I won’t make that mistake again,” or “I was so worried when I got lost at the zoo,” and “That was just like that time I couldn’t find mom; in the grocery store.”
Emotional Memories: Like the movie ‘Inside Out,’ children who are developing normally hold onto memories, emotions, and coping responses. In the movie, memory drawers hold a vast array of filed information. Likewise, this important metaphorical film shows that our emotions are important guides for our experiences and identities.
Experiences must be sorted, grouped, and understood. With autism, the filing system might not be so organized.
Insight enacts emotional memories. Children with poor emotional insight often remember isolated events and do not have a framework with emotional labels that group memories into learning experiences.
Some children with autism do not draw upon social or emotional memories, and thus they struggle to describe these experiences.
Other insight issues found in teenagers
Dissociation or developmental trauma: There can be insight issues even for children without any developmental disabilities. Children who have experienced developmental trauma may have that ‘deer in the headlights’ look when discussing emotional experiences. Sometimes, the experience or series of experiences is so distressing that the child detaches from their own emotions as a way to escape the pain of the event. This dissociation can happen to normal kids from normal families who simply have experienced upsetting events in their lives.
A preference for ‘the facts:’ There is a style of processing that is more ‘systemizing’ vs. ‘sympathizing.’ The ‘systemizers’ tend to enjoy facts, numbers, algorithms, math, and systems that make logical sense. The ‘sympathizers’ are more comfortable in the land of feelings and relationships. Children with poor insight tend to be more systemizing and may struggle when information becomes more ambiguous or open-ended as with social-emotional connections.
ADHD: Research is finding that children’s brains with ADHD develop differently. Children with ADHD often have lower insight than neurotypically developing children.
Often, a child with ADHD responds so quickly to stimuli coming in that they cannot correlate their behavior to their action. As a result, children with ADHD can be less mature than their peers, and they are unaware of how their choices impact how peers view them.
Some children with ADHD tend to be less interested in emotions because their minds are busy with other things. For example, a child with ADHD might explode when frustrated with a sibling and then forget the incident 10 minutes later, thus not learning from the emotional experience.
Parents may be gasping for breath as they notice that their child has completely moved on from the tough moment. Unfortunately, a failure to label and recognize emotions early also means a child is not learning from these experiences or attending to their own emotional response.
‘Shadow Effect’: The problem with this lack of learning from experience is that the child continues to fall further and further behind their peers.
Sometimes, the compounded effect of missing out on social experiences and associated memories is referred to as the ‘Shadow Effect’ of disabilities.
In a sense, these missed opportunities tend to ‘stick with you’ and continue to wreak havoc on your social skills. Therefore, early intervention is often needed to stop this chain of events and get a child on track developmentally.
Other cognitive or developmental delays: Some children and teens are especially immature for their age. They are developing more slowly in terms of cognition, adaptive behavior, and emotional development. When asked how they feel, they often report that they don’t know.
Depression versus autism: For clinicians diagnosing disorders, it is essential to differentiate the limited emotions shown in depressed children from the poor insight seen in autism.
Depressed teens tend to appear flat and offer limited responses. The difference is that the teenagers with Autism Spectrum Disorders who have these challenges are generally not depressed. However, if they are depressed, they tend not to have insight into their emotions.
It can be beneficial to ask the parent how a teenager feels and then ask the teenager during the interview or questionnaires of the assessment.
For children with autism, the ratings between parent and child tend to differ dramatically. For example, the child reports a near-perfect emotional profile, but the parents are concerned about aggression, depression, or anger.
By contrast, most depressed teenagers are well aware of their emotional distress and will report it quite accurately.
11 Things Parents Can Do To Help Kids Form A Healthy Identity
- DO practice emotional language with your child. For example, label your own emotional experiences and mention your coping strategies. Comment on an emotion your child may be feeling. For example, you can say, “when people are left out of a group event like that, most people feel lonely and sad. Do you feel like that at all?” Sometimes you will be wrong, which is okay. Your child may say, “I don’t feel sad.” That’s okay too. You have opened the door to talk about feelings.
- DON’T assume your child feels just like you. If your child feels okay about something that upset you, let that be an OK answer. This moment can be particularly hard when there is a death of a loved one. Your child may seem somewhat flat or unaffected. Often, it will take 3-6 months for a child to begin grieving. After they notice their parents are starting to heal, they are safe to feel their feelings. No matter your child’s response, your job is just to listen. Offer your support and say something like, “I am here for you.”
- DON’T talk over your child. If the experience is negative, use a few words and guide your child to calm down with a strategy that works well for them. Examples of strategies include listening to music, jumping on a trampoline, snuggling under a blanket, or sitting in a cozy chair. After your child is calm, it is important to check back in about the emotions. Try to discuss how things felt in their body and how their body is starting to feel now.
- DO give feedback. “Feedback is king” when teaching any new skill, including insight. Give specific praise and feedback, so your child has a clear view of their strengths and weaknesses. Be positive yet realistic.
- DON’T overdo the praise. Parents often make the mistake of being overly positive in their feedback. Feedback is only helpful if it is true, specific, and constructive. Don’t tell your child he’s the next Ronaldo in soccer if he isn’t. Instead, point out attributes that your child can verify. For example, “You got the highest grade in the class on your math test. You are really good at math.”
- DO help your child understand who they are. Encourage and voice your child’s strengths in emotional attributes like kindness, positivity, and willingness to help others. Be clear and specific.
- DO seek therapy. If your child has poor personal and emotional insight, your child needs to participate in psychotherapy with a clinician who works with children and teens who struggle with a lack of insight. When it does not come naturally to express emotions and make those personal connections, psychotherapy can be a big help.
- DO encourage goal setting: For the personal responsibility component, try to notice strengths within your child and make reasonable connections like “You work so well with the younger kids at the community center; maybe you could do a job that involves children.” Or “You are a computer whiz; you could think about computer science or computer programming as a career (instead of professional gamer).”
- DO encourage authentic experiences: Help your child see the reason or purpose behind an activity. A week-long shadow internship in a career of interest can be helpful in seeing why we take certain classes or need to make certain grades.
- DO talk to the teacher about opportunities. If your child is struggling to develop a personal identity, many teachers will have fun ideas. If you happen to have a teacher this year that really ‘gets it,’ reach out about self-exploration assignments. These kids and teenagers also do very well with teachers who see their strengths and can think outside the box regarding assignments and encouragement in a certain field or subject.
- DO model and role-play emotional expression. Engage in a role-playing activity with your child to identify emotions. Try emotions scrapbooks: Take pictures of each of you making the face you would make when you experience a certain emotion. With a younger child, you can put these pictures in an emotion book and note the experiences that would make a person feel that way. Use this book as a reference together to discuss feelings. For an older child, you can make a poster together using cutouts from magazines. Keep it fun and let your child get creative with different experiences and which emotions they may invoke. See more fun activities like this in the Cadey assessment at the bottom of this page.
When to Seek Help for Lack of Insight in Childhood
If you have concerns about lack of Insight for your child despite working on this skill, it may be really helpful to see if your child meets the criteria for autism, ADHD, or depression. Seek a testing psychologist who can rule out all of these diagnoses.
Professional Resources for Lack of Insight in Childhood
- Testing psychologist or neuropsychologist: to provide an evaluation for diagnostic clarification; testing social, emotional, cognitive, learning, and attention to provide a profile and any relevant diagnosis
- Group therapist: to provide direct strategies and practice to improve social skills. A psychologist, licensed professional counselor, school psychologist, or social worker may run a social skills group
- Psychotherapist: to provide Cognitive Behavioral Therapy (CBT) interventions that have been shown to be effective in helping children make gains in recognizing and understanding emotions, gaining personal insight, improving perspective-taking and social skills, and managing depression and anxiety
- Applied behavior analyst (ABA) therapist: to provide Applied Behavior Analysis using principles of reinforcement to increase desired behaviors like communication and language and to decrease undesired behaviors like tantrums. For older children, ABA may be a good way to address personal responsibility, social skills, conversation, and social perspective-taking
- Speech and language pathologist (SLP): to provide speech and/or language support. The SLP is an important member of your treatment team if your child has language delays. Treatment works best if all team members can communicate with one another to make sure your child is getting comprehensive services
Similar Conditions to Lack of Presence in Childhood
If your child is struggling with a similar problem not directly addressed in this section, see the list below for information about other related symptom areas.
- Restricted patterns of behavior or interests: children with poor insight often have other social challenges, so it is important to look for rigid patterns of behavior or interests
- Pragmatic language: children with poor insight may also have challenges with social language
- Social motivation: children with poor insight may also have difficulties with perspective taking and with social motivation
- Self-esteem: children with poor insight may have self-esteem issues. They may not have the confidence to make social connections or the willingness to fail or make a mistake. Building social skills and social successes can be so important as it builds confidence and provides sources of pride
References for Lack of Insight in Childhood
 Kroncke, Willard, & Huckabee (2016). Assessment of autism spectrum disorder: Critical issues in clinical forensic and school settings. Springer, San Francisco.
 Lawrence Heller. Healing developmental trauma: How early trauma affects self-regulation, self-image, and the capacity for relationships
 Fein, Deborah (2011). “The Neuropsychology of Autism”
Resources for Lack of Insight in Childhood
Mendler, Allen (2013). Teaching your students how to have a conversation.
Ozonoff, Sally & Dawson, Geraldine & McPartland, James C. (2014). A parent’s guide to high functioning autism spectrum disorder: How to meet the challenges and help your child thrive.
UCLA PEERS Clinic https://www.semel.ucla.edu/peers
Giler, Janet Z. (2000). Socially ADDept: A manual for parents of children with ADHD and / or learning disabilities.
Baker, Jed. (2006) Social skills picture book for high school and beyond.
Baker, Jed. (Retrieved 2017). Social skills books and resources for ASD.
Gray, Carol & Attwood, Tony (2010). The New Social Story Book, Revised and Expanded 10th Anniversary Edition: Over 150 Social Stories that Teach Everyday Social Skills to Children with Autism or Asperger’s Syndrome, and their Peers.
McConnell, Nancy & LoGuidice (1998). That’s Life! Social language.
Erikson, Erik. Stages of Psychosocial Development.
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