What is celiac disease?
Celiac disease (CD) is a genetic digestive disorder that affects about 1 in 100 people. Those with celiac disease are unable to digest gluten, a protein found in wheat, rye, barley and derivatives of those grains.
When the disease is left undetected or untreated, a child with celiac disease may experience gastrointestinal problems, slowed gross motor development and learning problems. With strict adherence to a gluten-free diet, a child with celiac disease is able to live a normal and happy life.
What should I watch for?
While on a gluten-free diet, it is unlikely that a student with celiac disease will exhibit any noticeable symptoms of disease. But regardless of lack of symptoms, a strict gluten-free diet is a medical requirement for the child’s health. Gluten, even in small amounts, damages the intestine.
If a child ingests gluten, he or she may exhibit one or more of the following:
- Bloating, cramps, or foul-smelling gas
- Irritability or short-term memory problems, which may interfere with school performance
The severity of these symptoms will vary, but are not likely to escalate to a state of emergency requiring medical intervention. Parents should be notified if gluten is ingested.
Similar symptoms may exist between undiagnosed celiac disease and Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD). It would be prudent for classroom teachers to observe students with behavioral and/or learning problems with this in mind.
What are the restrictions?
A student with celiac disease who complies with the gluten-free diet will be able to actively participate in all academic and social activities with few exceptions. Most activities involving food products would be off limits, unless the food is gluten-free.
Common products with gluten*
- Bread products, cereals, crackers and pasta
- Pastries, donuts, cookies, cakes, and other desserts
- Many snack foods
- Some candies and chewing gum
- Finger paints
- Play Dough and some crayons
- Some paste/glue
*gluten-free versions of most food products are now widely available
Arts and crafts
Some materials used for arts and crafts projects may contain gluten. Paste-type glues and Play Dough are potential hazards and should be investigated. Crayons may also be a problem for small children. Work with the child’s family to provide safe materials or an alternative project.
Limited selections available in school cafeterias mean gluten-free choices may not be available. It is the responsibility of the child’s parent(s) or guardian(s) to work with the school dietitian to provide the student’s lunch, work with the cafeteria staff to have alternative gluten-free items available, or send their child to school with a packed gluten-free lunch.
Keep parents or guardians informed of classroom activities involving food. Working as part of a team with parents or guardians to have the appropriate gluten-free substitutes available will allow the child to participate in activities, rather than feeling left out or forgotten. An emergency supply of snacks and treats at school may be helpful.
All products containing any of the gluten-containing grains or flours (wheat, rye & barley) must be completely avoided. Be aware that the following are types or forms of wheat and therefore must also be avoided: spelt, duram, graham, semolina, couscous and bulgur. In addition, oats must be avoided unless they are certified gluten-free. Safe grains and starches include rice, corn, potato, tapioca, bean, sorghum, soy, arrowroot and nut flours.
How Can I Help?
The importance of communication between the parent(s) or guardian(s) and the teacher cannot be over-emphasized. As with all diseases, it is imperative that the teacher respect the wishes of the family. Children frequently share food. It is important that the classroom teacher be aware of food sharing when it involves the child with celiac disease.
Maintaining a gluten-free diet in a “gluten-filled” society can be difficult. The family and your student with celiac disease will certainly appreciate all of your support.
This article has been assessed and approved by a Registered Dietitian Nutritionist