The SOS Approach to Feeding is a Transdisciplinary Program for assessing and treating children with feeding and weight/growth difficulties. It has been developed over the course of 20 years through the clinical work of Dr. Kay Toomey, in conjunction with colleagues from several different disciplines including: Pediatricians, Occupational Therapists, Registered Dietitians, and Speech Pathologists/Therapists. This program integrates motor, oral, behavioral/learning, medical, sensory and nutritional factors and approaches in order to comprehensively evaluate and manage children with feeding/growth problems. It is based on, and grounded philosophically in, the “normal” developmental steps, stages and skills of feeding found in typically developing children. The treatment component of the program utilizes these typical developmental steps towards feeding to create a systematic desensitization hierarchy of skills/behaviors necessary for children to progress with eating various textures, and with growing at an appropriate rate for them. The assessment component of the program makes sure that all physical reasons for atypical feeding development are examined and appropriately treated medically. In addition, the SOS Approach works to identify any nutritional deficits and to develop recommendations as appropriate to each individual child’s growth parameters and needs. Skills across all developmental areas are also assessed with regards to feeding, as well as an examination of learning capabilities with regards to using the SOS program. TENET 1 = Myths About Eating interfere with understanding and treating feeding problems. TENET 2 = Systematic Desensitization is the best first approach to feeding treatment. TENET 3 = “Normal Development” of feeding gives us the best blueprint for creating a feeding treatment plan. TENET 4 = Food Hierarchies/Choices play an important role in feeding treatment. ASSESSMENT & DIAGNOSTIC PHASEThe Assessment Phase of the program usually begins with a direct referral from a child’s Primary Care Physician. However, referrals from individual therapists in the community, early childhood interventionists and/or programs, preschools, schools, other medical specialists, and/or parents are also accepted. (The referring party is always encouraged to attend the assessment with the family.) The child’s Primary Care Physician is then contacted to notify him/her about the referral request. A Trans-disciplinary team consisting of a pediatrician, psychologist, occupational therapist, speech pathologist and dietitian observe the child eating with his or her primary care givers in a Clinic setting. Families are asked to bring other family members who may be typically present at a meal if possible. Families are also asked to bring the plates, bowls, utensils etc. that the child usually uses at home to the evaluation. The goal is for the family to bring with them, items to help the child feel as comfortable as possible in a clinic setting. The Clinic setting with the Transdisciplinary Team has become the preferred setting for the initial evaluation over the years of developing the program for the following reasons:
TREATMENT PHASEBased on the Initial Feeding Assessment, a child may be assigned to Individual Feeding Therapy, Group Feeding Therapy, given home programming with phone follow-up, or returned to the Community for treatment. When a child is already receiving feeding therapy with another provider, the preference is to return that child’s treatment to that provider with the additional recommendations/program given by the Transdisciplinary Team. The treatments and recommendations are, of course, given/conducted in close contact with the child’s primary care physician. Treatment of the feeding problem(s) with Dr. Toomey always uses the SOS Approach to Feeding Program. However, the basic structure in which the program is implemented depends on the child’s age and individual needs.
PEER FEEDING GROUPSThere are several advantages to completing a peer Feeding Group in the Clinic setting vs. a daycare or other more natural peer setting, including:
TREATMENT DESCRIPTION
The program format is essentially the same whether a child is being seen in a Feeding Group, or in Individual Feeding Therapy. DISCHARGE CRITERIA
Please feel free to contact us with any questions you may have about the program, or if additional information is needed for clarification. Kay A. Toomey, Ph.D. Developer, SOS Approach to Feeding, Pediatric Feeding Specialist, Pediatric Psychologist President, Toomey & Associates, Inc., Copyright 1998/2010 Kay A. Toomey, Ph.D. |