Methodological Components for Evaluating Treatment Effectiveness of the SOS Approach to Feeding: A Feasibility Study

There is a paucity of research that explores effectiveness of the Sequential Oral Sensory (SOS) Approach to Feeding (Toomey, 2023). Needed are specific procedures and sensitive outcome measures prior to engaging in an effectiveness study. This feasibility study (Orsmond & Cohn, 2015) included several steps 1) creation of a fidelity measure, 2) delineation of study procedures, 3) refinement of a behavioral coding outcome measure based on the Steps to Eating Food Hierarchy, and 4) inter rater reliability of measures. The SOS Approach was combined with individualized sensory integration for children with co-existing feeding and developmental sensory integration needs. This approach uniquely supports nutritional and social growth while providing parents with knowledge, tools and strategies for carryover at home. Twelve children, ages 2-11 years, with differences in sensory integration/ processing affecting feeding behaviors at home were recruited from a private clinic. Inter rater reliability was tested for the fidelity measure and the behavioral coding scheme. Coding was validated in the clinic and in previous study (Benson et al., 2013). Videos were coded in 10-second increments. Operational definitions were refined for coding home/clinic meals. The Parental Stress Index (PSI) and a visual analog scale (VAS) were explored pre/post intervention. Interrater reliability (IRR) for fidelity had a kappa of .79. Coding of feeding behaviors had IRR of 94% and was sensitive to change. VAS measured change in parent awareness, competence, and client progress. PSI reported change in parent stress and child stress indices. Posttest data collection was extended several weeks after families completed an intensive program. Findings demonstrate fidelity to the SOS Approach as well as sensitive outcomes using behavioral coding and parent reported measures. These evidence-based tools and procedures offer researchers and clinicians objective, meaningful outcomes.

References

Toomey, K. (2023, April 19). Feeding disorders in children. SOS Approach to Feeding. https://sosapproachtofeeding.com

Osmond & Cohn (2015). The distinctive features of a feasibility study: Objectives and guiding questions. Occupational Therapy Journal of Research, 1–9. https://doi.org/10.1177/1539449215578649

Benson, J. D., Parke, C. S., Gannon, C., & Munoz, D. (2013). A retrospective analysis of the sequential oral sensory feeding approach in children with feeding difficulties. Journal of Occupational Therapy, Schools, & Early Intervention, 6, 289–300. https://doi.org/10.1080/19411243.2013.860758