Celiac disease is a genetic autoimmune disease in which gluten, a protein found in wheat, rye, barley, and contaminated oats, attacks the lining of the small intestine. Children with this disease must eliminate gluten from their diet. This article provides educators with essential information on celiac disease and the federal laws that protect the rights of these students. A study of the educational and social challenges of children affected by the disease is presented so school personnel are aware of the effects of celiac disease on the school experiences of students in pre-kindergarten through grade 12. In addition, recommendations for the academic environment and school community are provided so school personnel can provide a positive educational experience for children who must eat gluten free.
Although the number of individuals who have celiac disease is somewhat uncertain, most doctors cite a ratio between 1:100 (Green & Cellier, 2007) and 1:133 people (Fasano et al., 2003), and others suggest the numbers may be even higher (Dalgic et al., 2011; Ludvigsson et al., 2013; National Foundation for Celiac Awareness [NFCA], 2013a; Riddle, Murray, & Porter, 2012).
Symptoms of celiac disease include diarrhea, abdominal pain, vomiting, short stature, anemia, weight loss, neurological problems, irritability, and osteoporosis (Green, 2005; Green & Jabri, 2003; Fasano & Catassi, 2005), although studies indicate that as many as 41% of individuals with the disease have no symptoms (Fasano et al., 2003). Children and adults with celiac disease avoid gluten, which means not eating foods made with wheat, such as pasta, bread, pizza, and baked goods. It is much more difficult to dodge the hidden gluten that is contained in other products, such as soy sauce, soup, salad dressing, chicken broth, and barbecue sauce. It only takes a very small amount of gluten to cause a reaction in some people with the disease, and so it is a daily struggle to stay gluten free.
Children with celiac disease experience a multitude of problems during their time in school. Challenges include a lack of gluten-free options and cross-contamination in school cafeterias; lack of microwave access; restricted bathroom use; classroom and art materials containing gluten; lack of refrigerator and freezer use for gluten-free snacks; and limited food options for holiday parties, birthday parties, field trips, and school-sponsored camps. Thus, children with celiac disease can face health problems, academic concerns, social challenges, bullying, and mental health issues.
Accommodations for children with celiac disease are assured under Section 504 of the Rehabilitation Act of 1973 and the Individuals With Disabilities Education Improvement Act (Korn, 2001; NFCA, 2012). Under Section 504 of the Rehabilitation Act of 1973 (United States Department of Labor, 1973), students with a disability may not be subjected to discrimination in any program that receives federal funds. Children with celiac disease are eligible for a 504 plan, which outlines the accommodations necessary for them to be safe and successful in school. With a physician's documentation, students can receive gluten-free lunches that are commensurate with what typical children are eating, as well...