The SOS Approach to Feeding is the primary treatment approach used at Emerge and is appropriate for children who have a significantly restricted diet.  SOS works to increase the range of foods that a child will eat. This program can be implemented in individual or group settings and includes a significant parent involvement and education component to ensure home carryover. 

What does feeding therapy look like at Emerge?

  • Start with movement to help regulate the body in our sensory gym.
  • Therapist, child, and caregiver transition to one of our treatment spaces.
  • Follow a routine including washing hands, blowing bubbles, wiping down, and setting the table.
  • A hierarchy of foods are then presented one at a time on every individual’s plate.
    • The hierarchy is made up of foods that are preferred and non-preferred by the child
    • The foods have physical and sensory similarities (e.g. similar in color, texture, size, shape, etc.).
    • Foods are explored through the sensory systems (e.g. sight, touch, smell, sound, and taste) and a play-based approach.
  • The session is concluded when the child,  therapist, and caregiver all participate in clean up.

Caregiver education is a valuable part of feeding therapy. Encouraging the caregiver to be present during the session can serve as a valuable tool for learning how to use the SOS Approach to Feeding at home with their child. Tips, strategies, and skills are provided during each session to support increasing the child’s food repertoire at home and school environments.

infant sitting in her highchair, holding a large raw carrot to her mouth
one girl and two boys eating at table together
Here are some signs of feeding difficulties:
  • Ongoing, poor weight gain, weight loss 
  • Ongoing gagging, coughing, and choking during meals 
  • Ongoing problems with vomiting 
  • More than one incident of gastro nasal reflux 
  • History of traumatic choking accident 
  • History of eating and breathing problems combined with ongoing respiratory issues 
  • Inability to transition to baby purees by 10 months 
  • Inability to accept any table foods by 12 months 
  • Inability to transition to cup by 16 months 
  • Has not weaned off all or most of baby food by 16 months 
  • Avoidance or aversion to foods of a specific texture or food group
  • Food range of less than 20 foods 
  • An infant who cries or arches their back during meal time 
  • The family is fighting about feeding and meal time.
  • Caregiver reports the child is difficult for everyone to feed. 
  • Family history of eating disorder, combined with a child with poor weight gain 

Toomey & Associates, Inc. © 1990/2017

Learn More


As an Amazon Associate we earn from qualifying purchases.

Tools and Materials
Tools to use during meal times:  For kids having difficulty transitioning to solids:

 Textured Chew

To make mealtimes more fun:


As an Amazon Associate we earn from qualifying purchases.

Related Blog Posts

Potty Training: Considerations for Children with Complex Needs

Is your child at the age where they are transitioning from diapers to potty training? Is it a struggle? Do they have complex needs, such as sensory sensitivities or communication difficulties, that require special consideration? We hear you and our team is here to...

Feeding Issues: When Signs Point to the GI Tract

Have you ever experienced a change in your appetite when you weren’t feeling well?  Experienced reflux?  Been constipated?  What happened?  Chances are that you were able to assess how your body was feeling and identify ways to make it feel better. Or you had the...

Say So Long to Sippy Cups!

Did you know that sippy cups are not actually part of early childhood development?  Say whaaaaaat!?  I know, our minds were blown too when we first learned this.So let's dig in a little more.  Sometimes sippy cups are necessary.  Your child's daycare may require them...

I Spy with my MYO eye….Mouth Breathing!

All you could ever want to know about mouth breathing straight from the Orofacial Myologist's mouth!10 General Reasons to Breathe Out of Your Nose:  Warms the air to the optimal temperature for our lungs Brings moisture into our internal system (We breathe through our...

¡Consejos para eliminar el estrés a la hora de comer!

Durante el mes de marzo de cada año, es posible que note un impulso para crear conciencia sobre la nutrición y los hábitos de alimentación y estilo de vida saludables. Muchas personas probablemente estarían de acuerdo en que es importante tomar decisiones informadas...

Tips to Eliminate Mealtime Stress!

During the month of March each year you might notice a push to bring awareness to Nutrition and healthy eating and lifestyle habits.  Many people would likely agree that making informed decisions about food, healthy eating, and exercise are important. What if your...

Picky Eater or Problem Feeder?

Did you know that Emerge currently has FIVE therapists trained in the SOS Approach to Feeding?  We have three speech-language pathologists and two occupational therapists who are now trained in this approach and this winter we will be offering two small groups that...

Cooking Up Good Speech and Language Skills

Photo from   Looking to engage your child in a fun activity that can build their language skills and fill their bellies? Cook with them! At Emerge, we frequently use cooking projects as a basis for working on speech/language, motor skills,...

5 Ways to Structure Mealtime to Facilitate Success

Get the body ready. Sitting at the table for an extended period of time can be difficult or even excruciating for children with sensory processing challenges. We can help children get ready to sit by introducing movement activities immediately before mealtime. Use...

Gluten Free Lunch Box-Class at Durham Whole Foods

From the Whole Foods Calendar: Thursday, September 3 The Gluten-Free Lunch Box: Free Workshop 6:00 - 7:00 pm FREE Join us for a free workshop presented by Debbie Jongkind, RD, LDN who is a Gluten-free Health Coach for people with Celiac Disease and Gluten Intolerance....