S.O.S Approach and Development

S.O.S Approach also known as, the Sequential Oral Sensory Approach to feeding was developed by Dr. Kay Toomey, as an effective way to address problematic feeding behaviors in a variety of settings and populations. Parents of children who will not eat or are “picky eaters”, are faced with a difficult challenge. SOS approach assesses the “whole child” focusing on the organ systems; sensory processing; oral-motor skills; learning, behavior; nutrition and the child’s environment. “The SOS Approach focuses on increasing a child’s comfort level by exploring and learning about the different properties of food. The program allows a child to interact with food in a playful, non-stressful way, beginning with the ability to tolerate the food in the room and in front of him/her; then moving on to touching, kissing, and eventually tasting and eating foods.” (Toomey & Associates, 2016)

Top 10 Myths at Mealtime

Myth 1: Eating is the body’s number one priority. Correct: The body’s first priority is breathing, second is postural stability is space.

Myth 2: Eating is instinctive. Correct: Eating must be positivly enforced by the body.

Myth 3: Eating is easy. Correct: Eating is the most difficult sensory task that a child can do!

Myth 4: Eating is a two-step process: sit down, eat. There are actually 32 steps to eating!

Myth 5: It is not of to play with your food. Correct: Always play with purpose, increase interactions with foods by touching, smelling and tasting.

Myth 6: If a child is hungry enough, they will eat. They will not stave themselves. Correct: Children need skills in order to eat an appropriate diet. If a child does not have the skill, they cannot eat.

Myth 7: Children only need to eat 2-3x a day. Correct: Children should eat 5-6x a day to maintain a steady metabolic rate and in order to meet appropriate caloric intake.

Myth 8: A child who won’t eat has either a behavioral or an organic problem. Correct: Most times it is a combination of both! Often, gastrointestinal problems are an issue.

Myth 9: Certain foods are eaten only at specified times of the day and only certain foods are healthy for you. Correct: Allow children to eat foods that will work for them.

Myth 10: Mealtimes are a proper social occasion and children should “mind their manners” at all meals. Correct: It is more important to teach children skills they need first.

Always remember that a food is considered new unless it is tried ten times! Rejecting a new food is normal and exposure is key!

Facts about fetal/infant development regarding tastes

Taste begins to develop at approximately 7-weeks gestation! Below is a table of developmental taste milestones:

Child’s age

Taste Milestone

7-8 weeks gestation

Appearance of specialized taste cells

10 weeks gestation

Mature taste cells develop

11-13 weeks gestation

Taste buds begin to develop with the majority on the dorsal surface of the tongue

12 weeks gestation

Fetal swallowing begins

6 months gestation

Increase in swallowing to sweet tastes inject tin amniotic fluid and a decrease in swallowing bitter taste injected. A liking for sweet and salty and a disliking for bitter are innately organized!

The flavor of the amniotic fluid reflects the flavor of the mother’s diet. The flavor of the mother’s diet in the last trimester impacts newborns responses to similar foods after birth. The flavor of mother’s milk also reflects the mothers diet. Breastfeeding facilitates acceptance of novel flavors also; this acceptance may generalize past specific flavor exposure.


Remember, interacting with new foods that may be non-preferred by a child is a new and at times difficult task. Start by slowly integrating the child’s senses of sight, touch, smell, and taste within the SOS hierarchy. A SOS-trained Speech-Language Pathologist is able to help integrate this hierarchy and teach parents and caregivers what to do to improve their child’s eating habits at home!


Gabrielle Cormace M.S., CF-SLP



Toomey & Associates. (2016). Retrieved from SOS Approach to Feeding: http://sosapproach-conferences.com

SOS: The Sequential Oral Sensory Approach to Feeding; A Review. PowerPoint from The Suffolk Center for Speech. (All information origionally presented by Kay A. Toomey PhD., Erin Ross PhD, CCC-SLP, and Bethany Kortsha, M.A., OTR and is property of the SOS Approach to Feeding.)




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