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May 4, 2022

Beyond Picky Eaters: The Sequential Oral Sensory (SOS) Approach to Feeding for Food-Sensitive Children

There are many reasons kids have food sensitivities. Some stem from a variety of developmental and sensory challenges. Here’s how the Sequential Oral Sensory (SOS) approach to feeding can help you feed your food-sensitive child more comfortably. 

Key takeaways: 

  • Identifying whether your child is a picky eater or a problem feeder can help you find solutions to feeding issues.
  • Children who are problem feeders may have developmental or sensory issues.
  • Eating can be a choking hazard for kids with oral-motor skills challenges.
  • The Sequential Oral Sensory (SOS) Approach to Feeding is an evidence-based therapy that can help children learn to eat better.
  • Speech and occupational therapy may be able to help.

Everyone has to eat…so what do you do when you’re running into feeding difficulties with your child? The solution depends on what’s driving your child’s behaviors. Some kids are picky eaters or go through phases where they refuse to eat certain foods. Other kids, however, have developmental or sensory issues that lead to them having difficulties with food.

It can be very difficult to discern which camp your child may fall into without the help of professionals, such as your child’s pediatrician. In this article, we’ll provide some information on food-sensitive children and the Sequential Oral Sensory (SOS) Approach to Feeding, which may be very helpful for getting a food-sensitive child to start eating comfortably.

Picky eaters versus problem feeders

Figuring out whether your child is going through a stage, is just a picky eater, or if they have developmental or sensory issues can be challenging. Here are some signs to help you determine if your child is a picky eater or a problem feeder.

Picky eaters:

  • Usually eat at least 30 different foods
  • May need to take a break from certain foods but will accept the food again after a few weeks
  • May be reluctant to try new foods but can tolerate having new foods on their plate
  • Will generally eat at least one food from each texture/nutrition group
  • May frequently have different foods at mealtimes but still eats with family

Problem feeders:

  • Usually eat a very limited range of foods, typically less than 20
  • Refuse food they’ve had before and will not eat it again
  • Will typically cry, become distressed, or refuse new foods altogether
  • Will avoid entire food textures/nutrition groups
  • Typically always eat meals specially prepared for them at different times than the family and maybe even in a separate space

If you have concerns about your child’s eating habits, consult their pediatrician. They may need to provide you with appropriate referrals, such as to a speech-language pathologist who specializes in feeding. If your child’s challenges are determined to be because of sensory issues, you may receive a referral to an occupational therapist.

Reasons your child may have feeding issues 

The majority of children with feeding problems are experiencing oral-motor issues, sensory issues, or a combination of both.

Oral-motor: Tell-tale signs of kids who are struggling with oral-motor skills are:

  • Stuffing food in their cheeks
  • Gagging
  • Vomiting
  • Refusing
  • Spitting out food

For kids experiencing oral-motor struggles, eating may actually present a choking hazard. They may be refusing food to avoid choking.

Sensory: Sensory challenges can also contribute to problems with feeding. Sensory issues generally come down to two things:

  • Hypo-sensitivity, which means a child has little or no oral awareness
  • Hyper-sensitivity; this is the result of over-awareness and/or overstimulation

Whether the issue is an oral-motor or sensory issue, the SOS approach can help.

What is the SOS Approach? 

All children need proper nutrition to survive and thrive. Children who are problem feeders may have challenges getting the proper nutrition with their limited eating habits. That’s why the SOS Approach to Feeding program was developed. Dr. Kay Toomey created this approach as a holistic way to remedy difficult feeding behaviors.

SOS is short for “Sequential Oral Sensory.” This evidence-based approach helps a child to interact with food in a playful way, lessening the stress of mealtimes. Areas assessed in this approach include a child’s:

  • Organs
  • Muscles
  • Oral-motor skills
  • Developmental stage/history
  • Physical senses
  • Nutrition
  • Learning and cognition
  • Environment
  • Behaviors

According to the SOS approach, eating doesn’t begin with the mouth. There are “six steps to eating,” which are:

  • The ability to look at the food and tolerate its presence
  • Interaction with the food without directly touching it
  • Acclimating ourselves to the smell of the food
  • Playing with the food, engaging the sense of touch, much like when babies are learning to eat
  • Learning how to taste foods, which may involve placing them on the tongue, in the mouth, or chewing them and spitting them out
  • Chewing and swallowing, which can be practiced

These six steps allow kids to explore and learn about food in a way that provides them with incremental exposure, slowly increasing their comfort level until they can eat multiple varieties of foods.

While it may be tempting to write off your child’s feeding challenges as your child being “picky” or having behavioral issues, it’s important to get them assessed properly. What they are dealing with may in fact be an oral-motor skills deficit or a sensory processing challenge. Evidence-based therapies such as the SOS approach can help you and your child make mealtimes an enjoyable experience while making sure your child receives the nutrition that they need.

Get support from a qualified occupational therapist in the Chicago, IL area

Realizing your child is struggling with food sensitivities can be challenging for both you as a parent and for your child. However, rest assured that there’s help available that can start turning mealtimes from stressful situations into playful and nurturing times.

If your child is struggling with problem feeding, you can help him or her improve at Lumiere Children’s Therapy. We offer full-service pediatric occupational and speech therapy, so your child can be as independent as possible.

Our occupational and speech therapists are trained in the SOS Approach to Feeding. Through the approach, we encourage children to interact with food in a playful, non-stressful way.

We help all children, including those with specialized diagnoses, such as:

  • Autism spectrum disorder (ASD)
  • Sensory processing disorder
  • Developmental delay
  • Prematurity
  • Fine motor delay
  • Cerebral palsy
  • Brachial plexus injury
  • Down syndrome
  • Learning delays
  • Visual processing disorders
  • Motor incoordination
  • Chromosomal abnormalities

Lumiere Children’s Therapy also provides a host of other pediatric therapies to help children with a wide range of physical, emotional, and developmental conditions achieve traditional childhood milestones.

Our services include:

  • Occupational therapy
  • ABA therapy
  • Speech therapy
  • Physical therapy
  • Developmental therapy
  • Social work
  • Early intervention
  • Augmentative alternative communication
  • Teletherapy

Lumiere Children’s Therapy is a full-service pediatric therapy practice located in Chicago. We focus on providing services catered to the developmental needs of children from birth to 18 years of age. Be sure to learn more about how our clinicians work diligently to improve the lives of the children and families they serve.

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