Picky Eaters and Problem Feeders

Oct 01 , 2017

Sequential Oral Sensory (SOS) Approach to Feeding is a therapeutic approach used to increase the variety of food a child eats. According to the SOS approach, eating is a learned behavior which is established through negative and positive reinforcements. The goal of the program is to create situations which positively reinforce normal healthy eating patterns. Feeding therapists collaborate with the child and family using the SOS approach to start on the path of healthy eating.

The SOS approach includes five main strategies to increase feeding: repetitive structured learning, modeling of eating, positively reinforcing interactions with food, making food manageable to eat, and teaching the physical properties of food. The feeding therapists utilize various interventions depending on the child’s age and cognitive/developmental level. For younger children, a sensorimotor and play focused approach is used. For older children, 6 years of age or older, the “food science” approach is used, which focuses on thinking and exploring sensory characteristics of food groups.


The SOS steps to eating follow a progressive hierarchy: the child tolerates the physical presence/sight of the food, interacts with the food, tolerates the smell of the food, touches the food, and lastly tastes the food. Each step comprises of sub-steps, totaling to 32 steps to eating. Positive social reinforcement is utilized to support attainment of each step on the hierarchy.


A problem eater or a picky eater is a child who is not eating a variety of food. A problem eater is a child who has a restricted range of foods (usually less than 20 different foods), cries or becomes distressed when presented with new foods, or refuses to eat entire categories of food textures. A picky eater is a child who has a decreased range of foods (usually 30 foods), but is willing to interact, touch, and taste new foods, and eat at least one food per food group.


If you have concerns about your child’s eating habits, contact one of our occupational therapists today!

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Feeding Intervention