The Sequential Oral Sensory (SOS) approach addresses problematic feeding behaviors. This feeding program assesses and treats the “whole child.” The SOS approach to feeding was designed by Dr. Kay Toomey. This program combines sensory integration, oral motor behaviors, cognition, medical and nutritional factors to manage children with feeding problems. The treatment is based on the typical developmental step or stages toward feeding to create a systematic desensitization hierarchy of skills necessary for children to progress with eating various textures and tastes and with growing at an appropriate rate for each child.
A key component for a successful outcome in this approach is coordinating occupational therapy with the feeding program. Sensory Integration therapy provided by an occupational therapist assists in the preparation of the child to interact with a variety of food smells, textures, and consistencies. A child with Sensory Integration issues can also benefit from CranioSacral therapy to help with feeding, sensory Integration issues, and especially self-regulation.
Prior to initiating the SOS feeding program, a child will be engaged in Sensory Integration activities to prepare the child for therapeutic feeding. The program is based on multiple presentations of food in a non-threatening manner. Food is presented in a playful way, which encourages interactions with foods. A child is never forced to eat or taste food. There are 32 levels of achievement required before a child is considered capable of chewing and swallowing food. The program considers that a child often bases their opinion about whether they will eat food on what the food looks like on a plate or tray. Food is presented sequentially considering factors such as shape and color. The shape or color often remains consistent throughout the therapeutic meal. Children spit out uneaten foods into a wastebasket, which brings the food to their mouth to terminate the food.
Carry over to the home is vital to the program’s success. Parents must incorporate family-style meals at home that require the child to pass the food around the table. Family-style meals encourage smelling and visualization of foods as the food is passed. Therapeutic feeding is also needed at home once the parent/family has observed treatment sessions and has been trained in the program’s method of food presentation.