New to this topic? Start with our companion article: Fussy Eater or Problem Feeder? A Brisbane Speech Pathologist Explains the Difference
If your child has a limited diet, gets upset around new foods, or struggles with certain textures, you've probably already tried all the advice — hiding vegetables, offering rewards, the "just try one bite" approach. And if those strategies haven't worked, a different kind of support may be needed.
The SOS (Sequential Oral Sensory) Approach to Feeding is one of the most well-known and widely used frameworks for helping children with feeding difficulties. It's the approach we use at Speaking Speech Pathology, and it's designed to help children build a positive, comfortable relationship with food — at their own pace.
What Is the SOS Approach?
The SOS Approach to Feeding was developed by Dr Kay Toomey, a paediatric psychologist, in the 1990s and has been in use for more than 30 years. It's a transdisciplinary programme, which means it draws on knowledge from speech pathology, occupational therapy, psychology, and nutrition.
At its core, the SOS Approach is built on one key idea: becoming comfortable with a food can be broken into small steps, from simply being near it through to eventually eating it. It's a framework for working out where a child is up to and what the next small step might be, not a fixed sequence that every child moves through in the same order. And if a child gets stuck at one step, they need support to move forward, not pressure to skip ahead.
The approach looks at the whole child, considering sensory processing, motor skills, medical history, nutrition, and behaviour. It's not about forcing food. It's about understanding why a child is struggling and working from there (Toomey & Ross, 2011).
A Gradual, Step-by-Step Approach
One of the key ideas in the SOS framework is that there are many small steps between a child first seeing a new food and comfortably eating it — from simply being near it, through to touching, tasting, and eventually eating it. Not every child takes the steps in the same order or at the same pace. Rather than expecting a child to "just try it," the SOS Approach recognises that every step forward matters and that a child who can touch a new food is making genuine progress — even if they're not eating it yet.
The full SOS Steps to Eating hierarchy is taught through the official SOS Approach to Feeding training programme. If you'd like to learn more about the specific steps, visit sosapproachtofeeding.com or work with a trained clinician who can guide you through the process.
When parents start recognising and celebrating these smaller steps — "she touched the carrot today!" — the pressure lifts, and that's often when progress starts to follow. In our experience, noticing those small steps takes some of the strain out of mealtimes for everyone at the table, and that's a real change in itself, whatever pace your child's eating moves at.
How Does It Work in Practice?
The SOS Approach is built around the principle of gradual, low-pressure exposure — gently helping a child become more comfortable with foods over time, at their own pace. It's always done in a positive, playful way. There's no forcing, no bribing, and no "just one more bite."
The specific strategies and session structures are part of the trained SOS programme, but in general terms, therapy involves creating positive experiences with food — through exploration, play, and building on what the child already accepts. A trained clinician will guide the process based on your child's individual needs.
This is also the part of feeding work that really needs a professional's eye. Problem feeding sits at the intersection of sensory processing, oral-motor skills, nutrition, and medical history, which is why a proper feeding assessment — often alongside a paediatrician, OT, or dietitian — matters before anyone starts changing what's on the plate. The "kinds of things" a feeding-trained speech pathologist looks at include the order foods are introduced, the sensory steps in between, and the whole mealtime rhythm of the family.
What the Evidence Shows, and What It Doesn't Yet
The SOS Approach has a clear rationale, more than thirty years of clinical use, and it is the approach Alex trained in. Its research base is smaller than that reputation suggests. A 2025 feasibility study by the approach's own research group describes the evidence as limited and emerging, and was designed to prepare for a randomised controlled trial that has not yet been run (Schoen et al., 2025). So the honest position is this: the principles underneath it, no pressure, gradual exposure and responsive feeding, are well supported more broadly; the structured program is widely used and our clinical experience with it is good; but a demonstrated effect of the program itself is still being tested. We'll always tell you what progress we expect for your child and review it with you.
Who Is It For?
The SOS Approach can help a wide range of children, including those who:
- Have a very limited food range, or have dropped foods from their diet
- Are highly sensitive to food textures, smells, or appearances
- Become distressed or anxious at mealtimes
- Have a history of medical issues that affected early feeding (such as reflux, prematurity, or allergies)
- Are autistic or have sensory processing differences
It's used from infancy through to the teenage years.
What Does a Session Look Like?
At Speaking Speech Pathology, a feeding session using the SOS Approach is built around your child's needs and comfort level. Sessions are play-based and low-pressure, with the goal of building your child's comfort and confidence with food. A key part of every session is parent coaching — we work closely with you so that what happens in therapy carries over to real mealtimes at home.
Sessions are family-centred. Speaking Speech Pathology is a mobile service, so feeding support can happen in the place where feeding actually does — your home. As a mum of two young boys, I know that the best feeding strategies are the ones parents feel confident using on a Tuesday night when they're tired and dinner needs to happen — not just the ones that work in a perfect, calm therapy scenario.
How Does It Fit with the Division of Responsibility?
We also draw on Ellyn Satter's Division of Responsibility in Feeding, which complements the SOS Approach beautifully. Satter's model is simple: parents are responsible for the what, when, and where of feeding, and children are responsible for whether and how much they eat (Satter, 2007).
This takes the pressure off mealtimes. When children feel safe and in control of their own eating, they're more likely to explore and try new things over time.
The National Health and Medical Research Council's Infant Feeding Guidelines — guidelines for infants and toddlers — also support responsive, child-led approaches to feeding, recognising that pressuring children to eat can be counterproductive (NHMRC, 2012).
What to Expect
Feeding therapy is not a quick fix — it takes time and consistency. With the right support, many children make meaningful progress. Parents often tell us that even before their child starts eating new foods, mealtimes become calmer and less stressful. That shift in itself can make a real difference to family life.
If your child is struggling with food and mealtimes are hard, you don't have to figure it out alone. With the right approach — one that works with your child, not against them — mealtimes can become calmer, and your child's food world can grow. Get in touch if you'd like to talk about what feeding support could look like for your family. Any actual clinical work — assessment, diagnosis, or therapy — happens in a consultation about your child, not from an article.
References
NHMRC (National Health and Medical Research Council). (2012). Infant feeding guidelines: Information for health workers. Australian Government.
Satter, E. (2007). Eating competence: Definition and evidence for the Satter Eating Competence Model. Journal of Nutrition Education and Behavior, 39(5), S142–S153.
Schoen, S. A., Balderrama, R., Dopheide, E., Harris, A., Hoffman, L., & Sasse, S. (2025). Methodological components for evaluating intervention effectiveness of SOS feeding approach: A feasibility study. Children, 12(3), 373.
Toomey, K. A., & Ross, E. S. (2011). SOS Approach to Feeding. Perspectives on Swallowing and Swallowing Disorders (Dysphagia), 20(3), 82–87.
Alexandra Bouwmeester is a Senior Speech Pathologist (B.Sp.Path Hons I, UQ; MSPA, CPSP) with specialist training in the SOS Approach to Feeding. She provides mobile sessions at home across Brisbane's south side and Logan — supporting children with feeding difficulties right where mealtimes actually happen.
