The SOS Approach to Feeding

This post is the beginning of a series on the Sensory Oral Sequential Approach to Feeding. Over the next few weeks, I’ll dive more deeply into the basic tenets of this approach and highlight some strategies for working with picky eaters and feeding issues.

A few years ago, I had the privilege of attending a 4-day Sensory Oral Sequential (SOS) Approach to Feeding Therapy workshop. This workshop was extremely enlightening and beneficial to the work that I do with picky eaters and problem feeders. The SOS Approach is the feeding therapy tactic that I use most often with children who are displaying feeding issues. Let’s take a deeper look at what the SOS Approach to Feeding Therapy is.


The SOS Approach to Feeding Therapy was developed by a Dr. Kay Toomey, pediatric psychologist, and Dr. Erin Ross, pediatric speech and language pathologist. It is a program designed to assess and treat children with weight or growth problems and feeding difficulties.

The program has 4 basic tenets:

  1. Myths about eating. There are many myths circulating about how, why, when, and where a child should eat. These myths interfere with how we understand and treat feeding problems.
  2. Systematic desensitization. This is a treatment for phobias where a patient is exposed to anxiety provoking items or situations. The patient is taught relaxation techniques to deal with the anxiety. This approach is considered the best first treatment to feeding problems.
  3. Normal development. Eating has a normal developmental path that it should follow. This normal path gives us the best blueprint for developing a feeding therapy plan.
  4. Food hierarchies and choices. Utilizing food hierarchies and recognizing the child’s choice in eating and feeding play an important role in feeding problem treatment.

What I like about the SOS Approach to Feeding Therapy:

  • It accounts for the fact that feeding issues have a number of factors into consideration. The SOS Approach to Feeding looks at all of the aspects of feeding issues – posture, sensory, motor, behavioral, emotional, medical, and nutrition – to create an individualized feeding therapy plan.
  • Normal feeding development is key. The entire approach of SOS Feeding Therapy is based on normal developmental stages and skills of eating. By looking at normal feeding development, we can better pinpoint what is happening and create a plan to treat the feeding issue.
  • Feeding goals are based on the child’s skills. Many feeding programs are based on the need to increase the volume that a child eats, which of results in increasing the child’s anxiety around eating. By focusing on improving the skills involved in eating, the SOS Approach treats the root of the feeding issue, leading to increased volume.

Stay tuned for this series that I hope helps you better deal with your picky eater!

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