Feeding Therapy Techniques

Sensory-Oral-Sequential (SOS)

The Sensory-Oral-Sequential (SOS) approach to feeding therapy is a comprehensive, evidence-based method designed to address feeding difficulties in children. Developed by Dr. Kay Toomey, this approach integrates sensory, oral-motor, behavioral, learning, medical, and nutritional factors to create a holistic treatment plan.

Key Principles of the SOS Approach

1. Child-Led: The SOS approach is child-centered, respecting the child’s pace and readiness. It encourages exploration and gradual acceptance of new foods without pressure.
2. Hierarchy of Skills: This method follows a structured hierarchy that progresses from tolerating food in a safe, pressure-free environment to interacting with it, smelling it, touching it, tasting it, and finally eating it. Each step builds on the previous one, ensuring the child is comfortable and confident at each stage.
3. Sensory Integration: This approach recognizes the importance of sensory processing in feeding. It addresses sensitivities to textures, smells, and tastes, helping children recognize their preferences and slowly but steadily become more comfortable with a wider variety of foods.
4. Positive Reinforcement: SOS uses frequent positive reinforcement to encourage progress and reduce anxiety around food. Recognizing and celebrating small successes is crucial for building confidence and motivation in both the child and the family.
5. Family Involvement: This technique involves parents and caregivers in the therapy process to ensure skill generalization and support at home. Educating families about feeding strategies and how to implement them in everyday life is a core component and essential to program success.

What will this approach look like in therapy sessions?

The SOS Approach will look slightly different for each child depending on their unique needs and temperament. However, this program always incorporates:

1. Assessment: A thorough evaluation of the child’s medical history, developmental background, sensory processing, and current feeding patterns. This helps tailor the therapy to the child’s specific needs. Outside referrals for underlying medical issues are made as needed.
2. Creating a Safe Eating Environment: Establishing a comfortable and non-stressful setting for meals, where the child feels secure and supported to learn and explore. The feeding therapist prioritizes building trust with the child and family throughout the first few sessions through spending time getting to know the child and including their interests in activities and discussions. Our therapists prioritize autonomy and will never force or pressure a child into eating a food.
3. Gradual Introduction of Foods: Following a step-by-step hierarchy, children are introduced to new foods in a systematic and sequential manner. The process starts with simply seeing and tolerating food while learning about it, then touching, smelling, and finally tasting and eating.
4. Therapeutic Play: Incorporating age-appropriate play into therapy sessions to make the experience enjoyable and engaging. Using games and activities related to food helps children feel more comfortable.
5. Ongoing Evaluation and Adjustment: Continuously assessing the child’s progress and making adjustments to the therapy plan as needed. This ensures the approach remains effective and aligned with the child’s development.

Food Chaining

The Food Chaining method is a systematic approach used in feeding therapy to help children expand their diet by gradually introducing new foods that are similar to those they already like. This method is particularly effective for children with feeding aversions and makes the transition to new foods less scary and more successful.

Key Principles of the Food Chaining Method

1. Individualized Approach: The method is tailored to each child’s specific preferences, sensitivities, and needs. It starts with a thorough assessment to understand the child’s current diet and food preferences.
2. Gradual Progression: Foods are introduced in small, manageable steps. Each new food is carefully selected to be similar in taste, texture, and/or appearance to a food the child already likes.
3. Positive Reinforcement: Emphasizes positive reinforcement and encouragement to build the child’s confidence and willingness to try new foods.
4. Family Involvement: Involves parents and caregivers in the process, providing them with strategies and tools to support their child’s feeding development at home.

What will this approach look like in therapy sessions?

The food chaining approach will look slightly different for each child depending on their unique needs and temperament. However, this program always incorporates:

1. Creating Food Chains:
   • Developing a series of small steps, or chains, that link the safe foods to the target foods. Each link in the chain is a food that is slightly different from the previous one but similar enough to be acceptable to the child.
   • For example, if a child likes chicken nuggets, the chain might progress from chicken nuggets to breaded chicken strips, then to grilled chicken strips, and eventually to grilled chicken breast.
2. Implementing Food Chains:
   • Introducing each new food gradually, starting with the closest match to the child’s preferred food.
   • Offering the new food repeatedly, in a positive and pressure-free environment, to encourage acceptance.
   • Using small, manageable portions to reduce the risk of overwhelming the child.
3. Monitoring and Adjusting:
   • Keeping track of the child’s responses to new foods and adjusting the food chains as needed.
   • Providing continuous support and encouragement, celebrating small successes, and addressing any challenges that arise.
4. Incorporating Sensory Strategies:
   • Addressing any sensory processing issues that may affect the child’s acceptance of new foods.
   • Using sensory play and exploration to help the child become more comfortable with different textures, smells, and tastes.