Sequential Oral Sensory (SOS) Approach to Children with Eating Difficulties

by Jourdan Kluger

We are fortunate to have Jourdan Kluger, a speech-language pathologist and feeding therapist at A to Z Pediatric Therapy address sensory and behavioral feeding difficulties. She presents a comprehensive, family-centered approach to developing oral-motor and other skills that help difficult feeders build positive interactions with food -- Dr. Stan

Eating can be and should be a fun, positive time in a child’s life. We love going out for lunch and dinner and meeting with friends and family. Mealtime is a social time, one that the entire family should be able to enjoy together. But some parents are left to wonder why mealtimes are often a battle. They have to ask “Is my child just picky or is eating hard for my child?” T hese are questions that therapists hear all the time.

Amanda Griffin previously discussed the signs and symptoms of problem eating in her post "Red Flags For Feeding Difficulties",and here I want to help you understand how therapists can assist families return to a normal, happier mealtime. On one hand, parents want their children to have a pleasant relationship with food and family meals. On the other, they often are challenged to make sure their young child is getting enough nutrition to gain and grow.

Team Feeding

The SOS (Sequential Oral Sensory) Approach to Feeding uses a team to assess the “whole child” -- looking at the development of sensory processes, oral-motor skills, learning and behavior, nutrition and the feeding environment. So everyone works together, psychology, pediatrics, occupational therapy, speech-language pathology and a dietitian. Most importantly, the SOS Approach to Feeding is family centered with the caregiver involved in all aspects, in order to help their child at home.

Wait – There Are Steps to Eating?

One of the first concepts addressed is the myth, “eating is easy - you sit down, and you eat!” That is not the case!!! For a child without eating difficulties it can be a 25-step process - for children with eating difficulties, up to 32-steps! The SOS Approach leads a child through these steps to eating. Treatment focuses on the child’s comfort level while he or she is exploring the properties of foods (the taste, texture and smell) in a playful, non-stressful manner. But sometimes they have to start with just tolerating food in the room, before proceeding to smelling, touching, tasting and eventually swallowing particular foods.

Working Through Food Groups

Many common complaints are that a child rejects entire food groups, eats the same foods over and over, overstuffs their mouth, or needs to have the foods broken into pieces. They may have difficulty with specific tastes, textures, and consistencies of food. A feeding therapist, using the SOS approach, can recognize and target oral-motor, sensory, and behavior challenges that a child may have—and then guide that child and the parents to make the progress needed to building a full diet.

Benefits of SOS

There is a “trick.” To work through the challenges and accomplish their goals, the parents and therapists have to learn how to follow the child’s lead. The therapist is not“doing“ to the child, or forcing the child to do anything. This approach builds trust and a sense of safety between the therapist and the child (and the family) to decrease anxiety and ensure success at each level. The goal is to build positive interactions with foods. In this way, children have great success increasing their number of preferred foods, developing age-appropriate feeding skills, and creating mealtimes that are positive and fun for the entire family! For more information

Sensory Therapies and Research "Star Center" Sequential Oral Sensory Approach

Jourdan Kluger 19 May 2015

Jourdan Kluger has both her bachelor and master degrees from the University of Florida in Gainesville, Florida.   Currently practicing at Read More

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