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Sequential Oral Sensory approach to feeding for children experiencing problems with food

Developed by Dr. Kay Toomey, the SOS (Sequential Oral Sensory) approach to feeding enables children to interact with and learn about foods in a playful, non-stressful way. Children are encouraged to progress up a series of steps to eating using "play with purpose" activities. Organizing the food in a logical hierarchy plays an important role in feeding treatment, beginning with the ability to tolerate food in the room, on the placemat, touching it, kissing it, smelling it, and eventually tasting and eating it.


How do I get started?

An occupational therapist trained in SOS will review your child’s feeding, sensory and developmental history and observe a typical meal. Oral motor skills are then evaluated by a speech pathologist.

What happens during a therapy session?

Sensory preparation in our sensory gym always comes first. Once your child is well-regulated we march, skip or jump to the eating room, where we continue with sensory warm-up activities for the mouth, such as blowing bubbles or windmills.

Next is food play for younger children, or food school/food science for older children. Food is presented in a logically orchestrated approach. Therapy can take place individually or in a small group with the participation of a parent or caregiver. Parent education including mealtime strategies for home, is a key part of the program

Your child might benefit from SOS Feeding if he/she:

  • Has extremely limited food choices (less than 20 foods, with foods being dropped and not replaced)

  • Chokes or gags during meals

  • Vomits regularly or has a history of reflux

  • Refuses to eat any of the foods in a texture group or a nutrition group

  • Cannot transition to baby food by 10 months of age

  • Will not accept any solid food by 12 months of age

  • Poor weight gain or weight loss

  • Meals are a battleground

What happens during an SOS session? Children:

  • Have positive experiences with food

  • Learn mealtime routines and cues to eating

  • Decrease resistance to touching, tasting and swallowing food

  • Increase the quantity of foods they try

  • Increase the volume of food they eat

What makes SOS different from other feeding programs?

  • It was developed in conjunction with other health professionals including psychologists, pediatricians, nutritionists, speech pathologists and occupational therapists

  • It integrates posture, sensory, motor, behavioral, emotional, medical and nutritional factors

  • It is rooted in normal development

  • Treatment incorporates systematic desensitization with a strong emphasis on sensory regulation, and avoids rewards.

  • Therapy can be implemented with one child or in a group

  • It is a family centred care program. The involvement of the family and carryover at home are essential to assessment and treatment

Why do we like SOS at POTS?

  • It acknowledges that eating is the most difficult sensory task your child must engage in

  • It incorporates both sensory and oral motor challenges in treatment planning

  • Research studies have shown it not only works but generalizes and continues to work

  • It doesn’t trick or force children to eat

  • It provides parents with specific strategies

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