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S.O.S. Approach to Feeding

The SOS (Sequential Oral Sensory) feeding program is an effective way to address problematic feeding behaviors in a variety of settings and populations. It focuses on increasing a child's comfort level by exploring and learning about the different properties of food, such as texture, taste, smell, and consistency. The SOS approach allows a child to interact with food in a playful, non-stressful way.

The SOS Approach is a trans-disciplinary feeding program that assesses and treats the whole child. Because feeding is the most complex of human physical tasks, it is critical that all the possible problem areas be examined when working with children who won't eat. The SOS approach follows a hierarchy of feeding, beginning with the ability to tolerate food in the room, in front of him/her, touching, kissing, and eventually tasting and eating foods. The SOS Approach to Feeding was designed and refined by Dr. Kay Toomey and her Feeding Teams over the past 15 years.


Is this child a candidate for referral? Yes-if any of the following are present:

  • Ongoing poor weight gain (rate re: percentiles falling) or weight loss
  • Ongoing choking, gagging or coughing during meals
  • Ongoing problems with vomiting
  • More than one incident of nasal reflux
  • History of traumatic choking incident
  • History of eating & breathing coordination problems, with ongoing respiratory issues
  • Inability to transition to baby food purees by 10 months of age
  • Inability to accept any table food solids by 12 months of age
  • Inability to transition from breast/bottle to a cup by 16 months of age
  • Has not weaned off baby foods by 16 months of age
  • Aversion or avoidance of all foods in specific texture or food group
  • Food range of less than 20 foods, especially if foods are being dropped over time with no new foods replacing those lost
  • An infant who cries and/or arches at most meals
  • Family is fighting about food and feeding (i.e. meals are battles)
  • Parent repeatedly reports that the child is difficult for everyone to feed
  • Parental history of an eating disorder, with a child not meeting weight goals

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