SOS Feeding Therapy and How to Use it at Home 

The Sequential Oral Sensory (SOS) feeding approach integrates motor, oral, behavioral/learning, medical, sensory and nutritional factors and approaches in order to comprehensively evaluate and manage children with feeding/growth concerns. The SOS feeding therapy approach is based on typical developmental feeding steps, stages and skills found in children. 

The SOS approach focuses on quality over quantity, the aim is to refine and develop feeding skills that are needed to be a successful, safe eater.  

SOS approach can be done in a variety of settings including individual feeding therapy, group feeding therapy or home programming with follow-ups/check ins. There are different goals for therapy vs family meals but an overarching theme is to keep mealtime as positive and structured as possible to help your children’s relationship with food and mealtime.  

SOS Feeding Approach

“Family meals” 

The goal is the volume of food consumed, especially for our children with nutritional and growth concerns. Here are some SOS feeding and mealtime tips to introduce at home!  

• Serve the meal at a set time at the family table with other members of the family present (for positive models!), family style (bowls in middle of the table for everyone to serve themselves), which encourages children to be an active member at the table and gives them autonomy over how much of each food they put on their plate!  
•  One “rule” of family meals is that everyone is served at least 1 spoonful or piece of food offered on their plate, this doesn’t mean they have to eat it!! Instead they can choose to “learn” about it (i.e. where it comes from, texture, smell, color of the foods.) 
• Family meals must include at least 1 food that you know your child will eat (i.e. preferred food), the focus of this meal is to expose your child to “non”-preferred foods while still supporting the volume of consumption through preferred foods.  
• If your child is tube-fed, try offering the tube feeding at this time to establish the relationship between mealtimes and feeling full.  
• Adults should focus on being good social role models during mealtimes (talking about how the food tastes, be descriptive about it!)  
• The child should not be the focus of the meal, but praise can and should be given for any good attempts at eating or exploring (through sight, smell, touch, taste or eating)! 
• Establish a clean up routine: have everyone pick up (encourages interaction) the leftover food from their plate and put it in a “bye-bye” bowl or trash bin when the meal is done. 

“Therapy Meals”  

Therapy meals are typically done with a SOS feeding specialist and then carried over at home. The goal of a therapy meal is fun exploration of new foods! 

The volume consumed is less important and can be done separate from mealtime since the goal is to work on skills and exposure, not eating (yet!) Children are encouraged to explore new foods and expand their food repertoire using systematic desensitization (the use of competing relaxation responses during exposure to a graduated hierarchy of stimuli known to cause anxiety—i.e. food), social modeling and positive reinforcement!  

Related Reading:

• Food Aversion 101: What You Need to Know
• Feeding Challenges: What’s Behind Them?
• 10 Tips to Get Your Child to Eat When They Refuse

About the Author

Allegra is a speech language pathologist at NAPA Boston! She enjoys working closely with children with medically complex needs and finding the best approach to enable them to communicate with others. One of her favorite things to do is spend time with her younger sister, Christina who has Down syndrome. She also enjoys spending a week each summer at Camp PALS, an overnight summer camp for young adults with Down syndrome.

About NAPA Center

NAPA Center is a world-renowned pediatric therapy clinic offering pediatric feeding therapy in intensive and traditional settings. The goal of NAPA’s feeding therapy programs is to provide families and their children with the skills and techniques necessary to love eating and to become safer, more comfortable, and confident in advancing their child’s feeding and swallowing skills. If you’d like more information on the Sequential Oral Sensory feeding approach or if you have any questions, contact our team today.