The Sequential Oral Sensory Approach to Feeding (The SOS Approach) is a transdisciplinary program designed to assess and address the reasons why a child is struggling to eat. Assessment occurs across seven different areas of human function involved in the process of learning to eat: organs, muscles, sensory, learning, development, nutrition, and environment. The SOS Approach uses a whole child perspective, integrating sensory, motor, oral-motor, behavioral/learning, medical, and nutritional factors for both assessment and intervention, resulting in strategies to comprehensively evaluate and manage children with feeding/growth problems. Success is determined by (a) intrinsically motivated and sustained interest in trying new foods, (b) enjoyment in and appropriate skills for eating and drinking a wide range of age-appropriate foods and fluids; (c) consumption of sufficient calories for optimal growth along a child's own percentile line on a growth curve, and (d) improved family understanding and functioning during mealtimes for the development of healthy relationships with food and each other.


  • Berlin, K., Davies, W. H., Lobato, D., & Silverman, A. (2009). A biopsychosocial model of normative and problematic pediatric feeding.Children's Health Care, 38(4), 263–282.
  • Bithoney, W. G., McJunkin, J., Michalek, J., Snyder, J., Egan, H., & Epstein, D. (1991). The effect of a multidisciplinary team approach on weight gain in nonorganic failure-to-thrive children.Journal of Developmental & Behavioral Pediatrics, 12(4), 254–258.
  • Boyd, K. (2007). The effectiveness of the Sequential Oral Sensory Approach group feeding program (. Doctoral dissertation). Retrieved August 12, 2008, from ProQuest Dissertations & Theses (PQDT) database. Dissertation Abstract International, B 69/01, p. 665.
  • Carruth, B. R., Ziegler, P. J., Gordon, A., & Hendricks, K. (2004). Developmental milestones and self-feeding behaviors in infants and toddlers.Journal of the American Dietetic Association, 104(1, Suppl. 1), s51–56.
  • Creech, E. (2006). Behavioral changes across ten weeks of SOS Approach to Feeding therapy. Unpublished manuscript.
  • Crist, W., & Napier-Phillips, A. (2001). Mealtime behaviors of young children: A comparison of normative and clinical data.Journal of Developmental & Behavioral Pediatrics, 22(5), 279–286.
  • Delaney, A. L., & Arvedson, J. C. (2008). Development of swallowing and feeding: Prenatal through first year of life.Developmental Disabilities Research Reviews, 14(2), 105–117.
  • Drewett, R. F. (1993). The infant's regulation of nutritional intake.In I. St. James-Roberts, G. Harris, & D. Messer (Eds.), Infancy crying, feeding and sleeping. New York, NY: Harvester Wheatsheaf.
  • Foy, T., Czyewski, D., Phillips, S., Ligon, S., Baldwin, J., & Klish, W. (1997). Treatment of severe feeding refusal in infants and toddlers.Infants and Young Children, 9(3), 26–35.
  • Gauderer, M. W. (1991). Percutaneous endoscopic gastrostomy: A 10-year experience with 220 children.Journal of Pediatric Surgery, 26(3), 288–292; discussion 292-284.
  • Gisel, E. G., Birnbaum, R., & Schwartz, S. (1998). Feeding impairments in children: Diagnosis and effective intervention.International Journal of Orofacial Myology, 24, 27–33.
  • Goldfried, M. R., & Davison, G. C. (1994). Clinical behavior therapy (Expanded ed.). New York, NY: Wiley.
  • Greer, A. J., Gulotta, C. S., Masler, E. A., & Laud, R. B. (2008). Caregiver stress and outcomes of children with pediatric feeding disorders treated in an intensive interdisciplinary program.Journal of Pediatric Psychology, 33(6), 612–620.
  • Medoff-Cooper, B. (2000). Multi-system approach to the assessment of successful feeding.Acta Paediatrica, 89(4), 393–394.
  • Sharp, W. G., Jaquess, D. L., Morton, J. F., & Herzinger, C. V. (2010). Pediatric feeding disorders: A quantitative synthesis of treatment outcomes.Clinical Child and Family Psychology Review, 13(4), 348–365.
  • Skuse, D. (1993). Identification and management of problem eaters.Archives of Disease in Childhood, 69(5), 604–608.
  • Toomey, K. ( 2002, March). When children won't eat: Picky eaters and problem and feeders. Paper presented at the Society for Developmental and Behavioral Pediatrics Annual Conference, Chicago, IL.
  • Williams, K. E., Field, D. G., & Seiverling, L. (2010). Food refusal in children: A review of the literature.Research in Developmental Disabilities, 31(3), 625–633.

Additional Resources