Find out what the gluten-free casein-free diet is, how it might help and how to enforce it at school
Many families have tried dietary intervention in an attempt to treat autism, a development disorder whose symptoms range from struggles with communication to sensory-processing issues to gastrointestinal disorders.
“There is a long history of parents reporting that dietary changes have really helped their children,” says Lisa Lewis, PhD, co-founder of the Autism Network for Dietary Intervention. While this [reportage] falls under the category of ‘anecdotal,’ it is very widespread,”
More recently the gluten-free, casein-free (GFCF) diet has people talking. Gluten is a protein composite in wheat, rye and barley. It gives bread dough its elasticity and baked goods their chewiness. Casein is a protein in dairy products. Both can cause inflammation in the intestine.
Gluten is in most flour, bread, cookies, pizza crusts, bagels, cereal, pasta, soy sauce and processed meats. Casein is in everything from yogurt to pudding to cheese. Eliminating them from a diet can be difficult under the best of circumstances.
Some parents of children with autism believe that dietary intervention can markedly improve the symptoms of autism, including chronic constipation, chronic diarrhea, and gastroesophageal reflux disease. Kelly M. Barnhill, certified clinical nutritionist and director of clinical care at the Johnson Center for Child Health & Development, a nonprofit organization in Austin, Texas, says that those changes likely result from a combination of factors. Some children may have celiac disease but have never received tests for it because parents often assume that gastrointestinal problems are common symptoms of autism. She also notes that many children with autism never have had normal bowel patterns, and simply removing casein can help with that issue.
Simply deciding whether dietary intervention and the GFCF diet are right for your child is the first critical step. Introducing new foods can be tricky because some children with autism spectrum disorders have extreme food selectivity—showing a preference for foods of a certain temperature or texture, for instance.
Another critical step is committing to the GFCF diet, particularly if your child eats his or her meals at school or in other places outside the home. Here are some tips to help ease the transition to the GFCF diet and to ensure that your school meets your child’s dietary restrictions.
Talk to your nutritionist to make certain that your child’s new diet has enough nutrients.
Read food labels; gluten and casein will appear on many of them.
Ask your nutritionist for a list of the ingredients that your child needs to avoid. For example, a label may not say “wheat” or “contains gluten” but will say “barley,” “spelt,” “malt,” “malt vinegar” or “farina,” all of which contain gluten.
Gradually expose your child to new foods, starting with foods that are similar in appearance or texture to foods your child likes. Avoid making mealtimes a battle.
Submit a detailed Individualized Education Plan (IEP) to the child’s school that explains your child’s dietary restrictions. Although parents generally must provide GFCF supplies, include a list of safe GFCF alternatives. Write your goals. Visit autismspeaks.org for a guide to writing an IEP.
Know your rights. Section 504 of the Rehabilitation Act of 1973 ensures that school districts provide food substitutes at no extra cost if a child is considered handicapped. A physician must verify your child’s food sensitivities.
Birthdays, special events and hands-on activities are common at school. Ask teachers to give you several days’ notice of these events so that you can plan an alternative activity or provide GFCF-alternative ingredients.
Provide lunches and snacks that your child can quickly and easily eat. Turn to p. 8 for ideas and GFCF lunchtime recipes. n
Easing the back-to-school-transition
The transition from lazy summer days to school can be difficult for anybody, but especially for families of children on the autism spectrum. Schedules and routines are changing, and children encounter new faces and new surroundings, all of which can be unsettling. To help ease the transition back to school, consider:
Touring the building in advance
- Taking your child to visit places in which social interaction is most common, such as playgrounds, recess areas and cafeterias
- Taking your child to meet with new teachers before the school year begins
- Driving your child along the bus route beforehand
- Getting a schedule of the school activities beforehand and discussing them with your child
- Getting a list of the curriculum for the year and discussing it with your child
Adjusting your child’s schedule to the school’s schedule, including bedtime and morning routines, lunchtimes and snack times, before school begins