A transdisciplinary program for assessing and treating children with feeding difficulties

Developed by Dr. Kay Toomey, the SOS (Sequential Oral Sensory) Approach to Feeding program is an effective way to address problematic feeding behaviors in a variety of settings and populations. Parents and caregivers of children who will not eat are faced with a difficult and often puzzling challenge. Because the interplay between weight gain and a child’ s experience of food can be complicated, there is rarely an easy solution when a feeding problem arises. The SOS Approach uses a transdisciplinary team approach which assess the “whole child”: organ systems; muscles; development; sensory processing; oral-motor skills; learning, behavior and cognition; nutrition and the environment.

The SOS Approach focuses on increasing a child’s comfort level by exploring and learning about the different properties of food. The program allows a child to interact with food in a playful, non-stressful way, beginning with the ability to tolerate the food in the room and in front of him/her; then moving on to touching, kissing, and eventually tasting and eating foods.

When Children Won’t Eat:

Assessment and Treatment Using the SOS Approach to Feeding
The Sequential Oral Sensory (S.O.S.) Approach to feeding is a trans-disciplinary program for assessing and treating children with feeding difficulties and weight/growth problems from birth to 18 years. It integrates posture, sensory, motor, behavioural/learning, medical and nutritional factors to comprehensively evaluate and manage children with feeding/growth problems.

Picky Eaters vs. Problem Feeders

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Picky Eaters

  • Decreased range or variety of foods that will eat = 30 foods or more
  • Foods lost due to “burn out” because of a food jag are usually re-gained after a 2 week break
  • Able to tolerate new foods on plate and usually can touch or taste a new food (even if reluctantly)
  • Eats at least one food from most all food texture groups
  • Frequently eats a different set of foods than the rest of the family, but usually eats with the family
  • Will add new foods to repertoire in 15-25 steps on Steps to Eating Hierarchy
  • Sometimes reported by parent as a “picky eater” at well-child check-ups

Problem Feeders

  • Restricted range or a variety of foods, usually less than 20 different foods
  • Foods lost due to food jags are NOT re-acquired
  • Cries and “falls apart” when presented with new foods
  • Refuses entire categories of food textures
  • Almost always eats different foods than the family
  • Adds new foods in more than 25 steps
  • Persistently reported by the parent as a “picky eater” across multiple well-child check-ups