Lucy Long, MS, CCC-SLP
Speech Language Pathologist

What is the SOS Feeding Approach?

SOS Feeding is “Sequential Oral Sensory” approach to feeding therapy that utilizes a systematic approach to address both the sensory processing and the oral motor skills a child needs to eat a wide variety of food groups and textures.

Can you please describe an appropriate candidate for the SOS Feeding approach?

The SOS Feeding approach is appropriate for children that are “problem feeders” and not “picky eaters”, which can sometimes be difficult to distinguish between. Picky eaters are those that have a limited variety of foods and will not easily eat, but they often will reluctantly touch or taste a new food. Picky eaters do not need SOS feeding therapy. A problem feeder, however, has an even more restricted variety of foods with more severe reactions to interacting with non-preferred foods, and is a candidate for SOS feeding therapy. Here are some questions to consider if you are concerned about your child’s eating:

  • Does your child have a decreased range or variety of foods (less than 20)?
  • If your child gets “burned out” on a food and takes a break from it, will they refuse that food still, after the break?
  • Does your child refuse entire categories of food groups (proteins, vegetables, etc.) or texture groups (hard foods, soft cubes, puree textures)?
  • Does your child almost always eat different foods at a meal than the rest of the family?
  • Have you reported concerns about your child’s feeding across multiple well-child check-ups?
  • If you answered “yes” to several of the above questions, talk to your child’s pediatrician about a referral for an evaluation to determine if feeding therapy would be warranted for your child.

Please note, the term “problem feeder” is used by the SOS Feeding approach program to delineate children who are outside the normal range of age-appropriate feeding behaviors, i.e. only being a "picky eater".

When should a parent(s) see their child’s pediatrician?

The following are some “red flags” that would warrant speaking to your pediatrician about a feeding evaluation:

  • If your child is having difficulty gaining weight appropriately or is losing weight
  • Consistent choking, gagging, and/or coughing during meals
  • Ongoing problems with vomiting
  • More than one incident of gastro-nasal reflux (reflux that comes out of the nose)
  • Inability to transition to baby food purees by 10-months
  • Inability to accept any table food solids by 12-months
  • Or, if you feel that several of the above describe your child, SOS may be appropriate

What can a parent(s) do? 

  •  Have your child help you prepare foods (at a developmentally appropriate level- may be stirring, pouring, etc.)
  • Show them what positive eating looks like. Have family meals (dinner time) together frequently and at the table. Have a happy face, voice, and attitude about eating the meal.
  • Eliminate distractions while you’re eating- turn off the TV, iPad, and phones
  • Talk about the sensory properties of the food you’re eating (what it looks like, how it feels, is it a big or small smell, etc.)
  • Make feeding and mealtimes an enjoyable- even fun!- experience. Rather than force-feeding your child, allow them to have some positive interactions with foods. Let them feel the temperature, texture, see the color, etc. without the pressure that they will have to put it in their mouth and eat it. Processing those foods on a sensory level as well preparing their mouths to manipulate that food actually begins with seeing it, touching it with their hands, allowing it closer to their face and mouth, all before it enters their mouth. Allow them to have those exposures at home to explore foods without the expectation that they have to put it in their mouth every single time.

 What is the outlook and treatment? What are SOS therapy goals?

  • Every child is different, so we cannot say how long therapy will last, or provide any guarantees, but we do see our patients making consistent progress toward their feeding goals by using this approach.
  • Feeding goals will look different for every child, depending on current level of acceptance of different foods, oral-motor skills present, and how easily they progress through the “Eating Hierarchy.” This hierarchy is a basis for our goals, and operates on the understanding thateating does NOT consist of 3 steps- put it in your mouth, chew, and swallow. Eating is actually made up of over 25 little steps that end in chewing and swallowing. These steps progress from tolerating looking at foods at closer distances, to interacting with them to touch, to then tasting, before a food is chewed and then swallowed. Our goals for SOS feeding are developed to progress this child through the steps of this hierarchy.

Overall, eating is meant to be a social, enjoyable, fun experience. Although refusal to eat is frustrating and can be frightening for parents, encourage your child to have positive interactions with foods. “Playing” with food is an excellent way for your child to explore foods, so provide them with those opportunities!

To learn more, below are recommended references:

Always consult your child’s physician first if you think your child may be a problem feeder. References are for informational purposes only and they are not intended to replace physician and/or feeding therapy treatment(s).