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November 27, 2019

Feeding Issues: What Is the SOS Approach to Feeding?

Evaluate and mediate your child’s food-related issues to give them a healthy and nutritious future

Mealtime is supposed to be a healthy activity that involves nourishing our bodies, refilling our energy stores, and communing with our loved ones — if it all goes well. But as many parents know, feeding your child can often present a range of challenges.

It’s easy to worry about the overall well-being of our children and tempting to chalk up mealtime frustrations to an inconvenient phase of willfulness that will eventually pass. However, there are legitimate issues that can cause a child to refuse food, and working towards receiving the proper diagnosis and therapy will ease your mind and improve the health of your child. Learn more about how food refusal issues are diagnosed, and how the SOS approach to feeding may help your child overcome eating-related obstacles.

The difference between a picky eater and problem feeder

Some children are picky eaters or go through a stage of refusing certain foods. Others have oral-motor or sensory issues that contribute to challenges with eating. It can be challenging to assess whether your child is a picky eater or a problem feeder. Some signs of being a problem feeder include:

  • Having a restricted range of foods they will eat willingly; usually less than 20 food items.
  • Refusing to eat food they once ate regularly and refusing to accept it again in the future.
  • Refusing entire food groups or texture types.
  • Requiring different meals or accommodations than the rest of the family.
  • Acting out emotionally when presented with new food, including behaviors such as crying, protesting, or having a tantrum.

If you are concerned about your child’s feeding issues, consult with your pediatrician about your mealtime experiences. You may need a referral to a speech-language pathologist with a feeding experience. An occupational therapist may also need to be consulted if your child’s issue is sensory-related.

Although eating seems like a natural biological process, it’s actually quite complex. Eating involves all seven areas of human functions and requires each one to be working correctly and able to integrate with the other areas. In order to chew, the jaw must move in a rotary motion while the tongue pushes food up and down and from side to side to break it down. There are several steps happening at once, and although it’s second nature to most of us, that presents challenges to children with a skill deficit.

Most children with feeding issues are either experiencing oral-motor issues, sensory issues, or a combination of both.

  • Oral-motor: Children who lack the oral-motor skills to manage food will often pocket the food in their gums, gag, refuse, vomit, or spit out food. Eating can actually be dangerous for a child who is behind on oral-motor skills, and your child may be refusing food as a self-defense mechanism to avoid choking.
  •  Sensory: Sensory issues can be complicated, but if a child refuses to eat due to sensory reasons, it’s generally due to either hypo-sensitivities, which means there is little to no oral awareness, or hyper-sensitivities, which are the result of too much awareness.

The SOS Approach to Feeding program

Feeding issues are challenging to deal with and especially concerning because every child needs proper nutrition. The SOS Approach to Feeding program was developed by Dr. Kay Toomey to address feeding behaviors in an incremental way that assesses the whole child. SOS stands for Sequential Oral Sensory, and involves evaluating the following factors to work towards a comprehensive understanding of a child’s food-related issues:

  • Organs
  • Muscles
  • Development
  • All eight senses
  • Oral-motor skills
  • Learning history/style/capacity
  • Nutritional status/history
  • Environment

The SOS Approach encourages children to explore and learn about food in a playful way that increases their comfort level gradually. The steps involved are based on the developmental steps and skills experienced by typically developing children. The six major “steps to eating” include:

  • Tolerating the physical presence or sight of food in the room and in front of the child
  • Interacting with food in a low-pressure way without directly touching it
  • Growing accustomed to smelling the odor of foods
  • Learning how foods feel by touching them directly
  • Tasting foods
  • Chewing and swallowing foods

If you’ve never personally experienced a feeding issue, it can be difficult to relate to your child’s challenges. However, there is a chance that your child is struggling with a skill deficit and not a behavioral problem. If mealtime frequently feels like a battleground at your house, it’s worth researching feeding issues and having your child evaluated by a specialist. Therapeutic methods such as the SOS Approach to Feeding can improve the quality of your family life and the overall health and well-being of your child.

Lumiere Children’s Therapy is a full-service, multidisciplinary pediatric therapy practice located in Chicago that serves the developmental needs of children from birth to 18 years of age. Learn more about how our team of clinicians works to improve the lives of children and their families.

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