Mealtimes can be challenging for some children. They may eat only a small number of foods, avoid certain textures, become distressed around unfamiliar foods, or have difficulty eating enough to support their nutritional needs and growth.
For some children, these challenges go beyond typical picky eating and may benefit from support through paediatric feeding therapy.
The SOS Approach to Feeding is one approach used by trained feeding professionals to support children experiencing feeding difficulties.
Rather than simply asking, “Why won't my child eat?”, the SOS Approach considers:
“What might be making eating difficult for this child, and what skills do they need support to develop?”
If you're wondering whether your child's eating falls within typical picky eating or may indicate a broader feeding difficulty, you can also read our guide to picky eating vs problem feeding.
What is this approach?
SOS stands for Sequential Oral Sensory.
The SOS Approach to Feeding is a transdisciplinary program developed by Dr Kay Toomey and colleagues from a range of healthcare professions.
The approach recognises that eating is a complex skill involving many different areas of development and functioning, including:
Oral-motor and physical skills
Sensory processing
Learning
Developmental skills
Medical factors
Nutrition
Previous experiences with food
The child's environment and mealtime experiences
Rather than expecting every child to eat in the same way, the SOS Approach uses typical feeding development as a guide while recognising that every child has their own strengths, needs and pace of learning.
The goal is to meet the child where they are and support them to develop the next feeding skill.
You can learn more about the principles behind the approach directly from the SOS Approach to Feeding.
Eating isn’t just about putting food in your mouth
For some children, even being around a particular food can feel challenging.
The SOS Approach recognises that eating involves many steps. A child may need opportunities to become comfortable with a food before they are ready to taste or eat it.
For example, a child's progression might include:
Seeing a food → Being comfortable with it nearby → Smelling it → Touching it → Exploring it → Bringing it towards their mouth → Tasting it → Eating it
This means that touching, smelling or interacting with a new food can represent meaningful progress, even if the child hasn't eaten it yet.
The SOS Approach uses a gradual process known as systematic desensitisation, where children are supported to become more comfortable interacting with foods and developing the skills needed for eating.
Why does the SOS Approach use play?
Children learn many new skills through play and exploration, so play is an important part of the SOS Approach to Feeding.
Rather than making food stressful or focusing solely on taking a bite, therapists use “Play with a Purpose” to help children learn about food and develop feeding skills.
This might involve:
Exploring the colour or shape of a food
Touching, squashing or breaking food apart
Smelling food
Moving food around the plate
Learning how different foods feel
Bringing food closer to the mouth
Tasting food when the child is ready
Activities can be adapted to the child's developmental level, interests and individual feeding goals.
The aim isn't simply to get a child to “try a bite.” It is to help them build the skills, comfort and confidence they need to participate in eating and mealtimes. Feeding Therapy at Eat Speak Play
What happens during a feeding assessment?
Feeding difficulties can have many different contributing factors, which is why a thorough feeding assessment is important.
The SOS Approach recognises the value of a transdisciplinary team. Depending on a child's individual needs, their broader care team may include a:
Paediatrician or other medical professional
Occupational therapist
Speech pathologist
Accredited Practising Dietitian
Mental health professional
The team considers the whole child, rather than focusing only on what happens at the dinner table.
This can include exploring physical and oral-motor skills, sensory processing, development, learning, nutrition, medical factors and the child's environment and previous experiences with food.
During a feeding assessment, a child may be offered foods they already enjoy and feel comfortable eating, alongside foods they don't currently eat.
This allows the therapist to understand both the child's existing strengths and the areas where additional support may be helpful.
Learn more about paediatric feeding therapy at Eat Speak Play and how our feeding therapists assess and support children's individual feeding needs.
What does SOS feeding therapy look like?
Once a child's feeding skills and needs have been assessed, their therapist can develop an individualised treatment plan.
Therapy may occur individually, within a group or alongside a supported home program, depending on the child's needs.
While every child's therapy will look different, an SOS feeding therapy session may involve:
1. Getting the body ready
Children are better able to learn and explore when they feel comfortable and regulated.
A session may therefore begin with movement or other activities to support the child's readiness to participate.
2. Creating a predictable routine
A consistent routine can help children understand what is going to happen and feel more comfortable during feeding therapy.
3. Exploring food
Foods are introduced gradually, often beginning with foods the child already knows before moving towards foods that are less familiar.
4. Responding to the child's cues
The therapist observes how the child responds throughout food exploration.
If the child is comfortable and engaged, they may be ready to explore a little further. If they show signs of discomfort, distress or overwhelm, the therapist can adjust the activity or return to an earlier step.
The child's communication and cues help guide the pace of therapy.
Does my child have to eat the food?
Feeding therapy is about much more than getting a child to take a bite.
A child might initially work towards feeling comfortable with a food nearby. Over time, they may choose to interact with it, touch it, smell it, taste it and potentially eat it.
Progress doesn't always mean eating a new food straight away.
For some children, calmly interacting with a previously difficult or unfamiliar food can be an important step forward.
Our broader approach to feeding also incorporates responsive, child-centred principles. You can read more about responsive feeding therapy and why it matters in our feeding therapy resources.
Parents and caregivers are an important part of feeding therapy
Feeding therapy doesn't only happen in the clinic.
Parents and caregivers play an important role because everyday meals and snacks provide regular opportunities for children to experience food within familiar routines.
Parent education and coaching may help families understand:
What their child may be communicating during mealtimes
How to recognise signs of comfort, stress or overwhelm
How to support emerging feeding skills
How to reduce unnecessary pressure around food
How to create positive and predictable mealtime experiences
How to use appropriate feeding strategies at home
The goal is to develop strategies that work for the child and their family, while respecting family culture, routines, priorities and individual differences.
What does success in feeding therapy look like?
Success isn't necessarily having a child who eats everything.
Instead, feeding therapy aims to support children to develop the skills they need to participate in eating and mealtimes while building greater comfort and confidence around food.
Depending on the child, progress may include:
Becoming more comfortable around unfamiliar foods
Exploring a wider variety of foods
Managing different food textures
Developing chewing and oral-motor skills
Reducing stress around mealtimes
Increasing food variety
Supporting nutrition and growth
Participating more comfortably in family and social mealtimes
Developing a more positive relationship with food
Every child's goals will be different.
When should I consider feeding therapy for my child?
It may be helpful to speak with a feeding professional if your child's eating is significantly affecting their nutrition, growth, development, wellbeing or ability to participate in family mealtimes.
You may also consider seeking support if your child:
Eats a very limited range of foods
Has significant difficulty with particular textures
Frequently gags, coughs or struggles when eating
Finds eating or mealtimes particularly stressful
Has difficulty chewing or managing food safely
Has dropped foods from their diet without replacing them
Has feeding difficulties that are affecting family life
Feeding difficulties can look different for every child. An assessment can help identify why eating may be challenging and what type of support may be appropriate.
For more answers, visit our Feeding Therapy FAQs.
The most important message for parents
If your child struggles with eating, there may be many reasons why food and mealtimes are challenging for them.
Eating is a complex skill.
The SOS Approach to Feeding aims to understand the factors contributing to a child's feeding difficulties and support them to gradually build the skills, confidence and comfort needed for eating.
Sometimes the biggest step forward isn't taking a bite.
It might be comfortably sitting alongside a new food. It might be touching it. It might be smelling it.
And, over time, it might be taking that first bite.
Every step counts.
Supporting children with feeding difficulties in Sydney
At Eat Speak Play, our paediatric feeding therapists support children and families experiencing a range of feeding challenges, including restricted food variety, sensory differences around food, difficulties progressing through textures and stressful mealtimes.
Our feeding therapy is individualised to each child and family, with a focus on understanding the reasons behind feeding difficulties and supporting meaningful, achievable progress.
We provide paediatric feeding therapy in Maroubra and Sandringham, supporting families across Sydney's Eastern Suburbs, St George and surrounding areas.
You can learn more about our child feeding therapy services or contact Eat Speak Play to discuss whether a feeding assessment may be appropriate for your child.
👉 Book a Free Discovery Call with one of our speech therapists.