What is S.O.S. Feeding Therapy?

I've mentioned before that my boys are problem feeders which pretty much means food can be our nemesis around here.
Every Monday, we head up to our O.T.'s office where the boys get to do full body sensory (we call it "big gym") and Food School...a.k.a. S.O.S. Therapy (I have become fluent in speaking acronyms).  

S.O.S. stands for "Sequential Oral Sensory" and was developed by Dr. Kay Toomey, Ph.D.
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The basics that I've picked up from watching through a two way mirror are...

• The therapists start with a sensory warm up: marching to the room, blowing a pinwheel or bubbles to warm up oral muscles, etc.
• They sit family style at a table and pass around each food on a plate.  It's important the kids are sitting, feet on the floor, prepared to eat.
• The therapists have a list of foods for the day - usually five or six.  They present each food one at a time, in a clear container (no branding, which is a big problem for our kids...I'll eat chicken nuggets but only a particular brand and if they're shaped like a dinosaur).  
• Before the food is attempted to be eaten, there is sensory warm up about the food.  What color is it?  Does it look crunchy or mushy?  Sweet or salty?  The therapists prepare all of the senses for eating.  Something that is easy to overlook but SO impacts our kids with feeding issues.
• When the food is presented, play is ENCOURAGED!  When presented with a carrot, they are to pretend it's a rocket.  They count down and make the rocket fly around the room.  Then the rocket has to go into the cave (kid's mouth) and you have to chomp down on the rocket.  Very neat.  This is my favorite part because for some of these kids, they cannot even stand being in the same room with a particular food, let alone have it in front of them.  Why?  Like anything in Autism, there's many answers and not all fit each child.  It may be one or the other or a combination of: sensory processing problems, gut problems (undiagnosed allergies, digestive problems, etc. all leading the child to the same conclusions: food = pain), an opiate effect occurring in the brain causing the child to crave or be addicted to particular foods (usually goldfish, fast food, or things with additives, especially MSG), or even fear of the unknown.
  So the real goal of food school is: Food = Good, not Bad.
• The foods are presented in a pleasing order - least offensive first.  For example, if hummus is on the list, there's no way that would be presented first; it would ruin the therapy session!  There is a build up to difficult foods.
• There is never any forcing of foods but they are encouraged to try everything and get treasure box if they participate in the session (regardless of how many foods are eaten).
• At the end for clean-up, they have to choose a few foods to spit into the trash can.  Obviously my kids love this.  What's the point?  It gets the food into their mouth.  Sure, they're not chewing up and swallowing the orange, but it touches their tongue and teeth when they spit it into the basket and that's a barrier broken!
• The therapist keeps track of each food and how the child handled it on an increasing scale: would he tolerate the food being in the room?  Would he play with it/touch it at all?  Would he put his tongue or teeth on it?  Would he chew?  And would he actually eat it?

So do I think S.O.S. works?  Yes.

We are encouraged to reinforce these techniques at home, as well, which helps.

I have seen an increase in interest about food in our home as well as actually trying new foods.  And last night, after months of eliminating, one of the twins actually requested hot dogs for lunch and then chicken nuggets (not even dinosaur) with KETCHUP.  Three foods that he had dropped for months he was now requesting unprompted!  

It might not have been hummus or Tilapia, but I'll take it!