Feeding Therapy The SOS Approach to feeding assesses the “whole child” examining organ systems, muscles, sensory functioning, oral-motor skills, learning & behavior, cognition, nutrition, and environment, in order to discern underlying reasons for problematic feeding behaviors.
Feeding Therapy and the SOS Method
In keeping with our emphasis on your child, IPT uses the SOS Approach to feeding therapy, which assesses the "whole child" (including organ systems, muscles, sensory, oral-motor, learning/behavior, cognition, nutrition, and environment) in order to discern underlying reasons for problematic feeding behaviors.
A SOS (Sequential Oral Sensory) Approach to Feeding Therapy has proven to be a very effective program to improve success with feeding. Feeding problems can be perplexing for parents and caregivers of children who have difficulty with mealtimes and eating, which is often attributed to the relationship between weight gain and a child's experience with food.
The SOS Approach utilizes exploration and learning about the various properties of food, in order to facilitate enhanced level of comfort for the child in regards to his/her experience with foods. This takes place through allowing the child to interact with foods in a safe, play-based, stress-free manner. A "hierarchy" is introduced in order to build up the child's tolerance for exposure to foods, beginning with the ability to tolerate the food in the room and on the plate; then moving on to touching, tasting and eventually eating foods.
SOS Approach to Feeding: Basic Tenets
- Tenet 1: Myths About Eating interfere with understanding & treating feeding issues
- Tenet 2: Systematic Desensitization based on the hierarchy of steps to eating is the best first approach to feeding treatment
- Tenet 3: “Normal Development” of feeding gives us the best blueprint for creating a feeding treatment plan
- Tenet 4: Food Hierarchies/Choices play an important role in feeding therapy
Background and Benefits/Who Developed the SOS Approach to Feeding
The SOS Approach to Feeding Therapy program has been developed over the course of 20 years through the clinical work of Dr. Kay Toomey, in conjunction with colleagues from several different disciplines including: Pediatricians, Occupational Therapists, Registered Dieticians, and Speech Pathologists/Therapists. It is based on, and grounded philosophically in, the "normal" developmental steps, stages, and skills of feeding found in typically developing children.
Does My Child Need Feeding Therapy?
The following is a list of red flags, or indicators, that your child may be a candidate for a referral:
- Ongoing poor weight gain and/or weight loss
- Ongoing choking, gagging or coughing during meals
- Ongoing problems with vomiting
- More than once incident of nasal reflux
- History of a traumatic choking incident
- History of eating and breathing coordination problems, with ongoing respiratory issues
- Parents reporting child as being “picky” at 2 or more well child checks
- 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 nutrition 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 (ie. 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 (parents not causing the problem, but may be more stressed and in need of extra supports)
How are Feeding Therapy sessions held/conducted?
Assessment: The child is assessed for all factors contributing to feeding difficulties: including motor, oral, behavioral/learning, medical, sensory, and nutritional factors.
Treatment: Treatment sessions utilize the typical developmental steps towards feeding to create a systematic desensitization hierarchy of skills/behaviors necessary for children to progress with eating various textures, and with growing at an appropriate rate.
- Children less than 18 months: Individual therapy sessions are held with the child, parent, and therapist. The Developmental Food Continuum is used for food exploration, particularly with purees & hard munchables.
- Children between 18 months and 7 years old: Peer groups are held with 2 or more children, therapist, and the parents observe through a two-way mirror with a separate therapist in order to learn the process of the session as well as strategies for carryover at home. The Developmental Food Continuum is used with exercises in order to move the child up the feeding hierarchy.
- Older than 7 years of age: Either individual session or peer feeding group is held. A specially modified approach is used: “Food Scientist Adaptation”
- Children with Autism Spectrum Disorder: Individual therapy sessions are held for children on the Autism Spectrum. An adapted version of the SOS approach is used, focusing on “safe exploration” of the foods at generally a more gradual pace of progression