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Additional Information for Speech Therapy
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.


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




Kids Can Do provides PROMPT therapy as an additional treatment approach for speech. PROMPT was developed by Deborah Hayden over a period of thirty years. It is a systematic approach that encompasses neuromotor principles, as well as kinesthetic, proprioceptive, auditory, and visual information to provide feedback to the speech system. The PROMPT technique uses touch, pressure, and specific placement, while creating auditory and visual awareness to support and develop movements of speech. The system has been used with a variety of speech deficits including: phonological disorders, developmental delay, dysarthria, dyspraxia, hearing impaired, autistic spectrum, and fluency disorders. PROMPT is meant to integrate the most effective, traditional and/or new, innovative approaches that augment, support and enhance speech production interventions thereby achieving the maximum treatment results.



The Picture Exchange Communication System (PECS) was developed in 1985 by Lori Frost and Andy Bondy in response to their difficulty in successfully using a variety of communication training programs with young students with autism. PECS was originally developed for use with preschool-aged children with Autism Spectrum Disorder and other communicative disorders who displayed no functional or socially acceptable speech. By this, the creators of PECS meant that these children did not speak at all, spoke only in a "self-stimulatory" manner, spoke only when prompted to do so, or were extremely echolalic. These childrens communicative difficulties are socially-related in that the children do not routinely approach others to communicate (or initiate), they actively avoid interaction with others, or only communicate in response to a direct cue to do so. Children using PECS first learn to approach and give a picture of a desired item to a communicative partner in exchange for that item. By doing this, the child initiated a communicative act for a concrete outcome within a social context. The PECS training protocol is based on research and practice in the principles of Applied Behavior Analysis. Distinct teaching strategies, reinforcement strategies, error correction strategies, and generalization strategies are essential to use to teach each skill. The PECS training protocol also closely parallels typical language development in that it first teaches the child "how" to communicate or what the basic rules of communication are. Then the children learn to communicate specific messages. Children using PECS learn to communicate first with single pictures, but later learn to combine pictures to learn a variety of grammatical structure, semantic relationships, and communicative functions.


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