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Using the 504 Plan at School to Accommodate a Student with Celiac Disease

Journal of Gluten Sensitivity Autumn 2016 Issue


Image: CC--U.S. Department of Agriculture

Celiac.com 10/25/2016 - The 504 Plan stems from Section 504 of the Rehabilitation Act of 1973. This section prevents discrimination against public school students in grades kindergarten through 12 because of disabilities. A 504 plan is meant to "remove barriers" to learning by providing a specific outline on how to make accommodations or modifications on a student-by-student basis.

The Rehabilitation Act of 1973 applies to all institutions receiving federal financial assistance, such as public schools. Under this law, public schools must provide a free, appropriate public education and not discriminate against disabled students. This law acknowledges that the disability may not require special education services, but a plan is needed to ensure the student receives an appropriate education accommodating the disability within the classroom. This law must accommodate a special diet, including the gluten-free diet for children with celiac disease.

The decision to enroll in the 504 plan is entirely up to you as a parent or guardian. Some parents find that informal discussions and accommodations have been sufficient for having the child's needs met at school. However, having a formal 504 plan in place is valuable, especially as teachers and staffing may change. The 504 plan guarantees by law that your child's needs are met throughout their school career and not just in certain classrooms. You can choose to utilize your 504 plan accommodations any time, and having them in place before you need them can save important time and resources. It can be helpful if your child develops symptoms from gluten exposure, or if you are having trouble with consistent accountability.

How to Start Your 504 Plan

  • First you need to contact your child's school. The 504 plan team should include:
  • Primary classroom teacher
  • School counselor or psychologist
  • School nurse
  • Director of food services
  • 504 plan coordinator

You will also need a doctor's note to show that your child has been formally diagnosed with celiac disease or non-celiac gluten sensitivity (gluten sensitivity). This note should outline the accommodations required to maintain your child's health, enabling him or her to have equal access to public education. Having a 504 plan in place will also make it much easier to apply for disability accommodation in college.

What Information is Included in a 504 Plan?

Generally you'll need to provide information about your child's diagnosis and needs including:

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  • Year of diagnosis
  • Amount of time on a gluten-free diet
  • Details on why a 504 plan is needed (including how a restricted diet affects a major life activity)
  • Child's developmental level and needs (are they self-reliant in managing the diet? do they need strict supervision? Etc.)

A 504 PLAN will specifically outline all of the details of how our child's celiac disease needs to be managed in the classroom. For example you and the 503 plan team can develop an action plan for:

  • Navigating school lunches
  • Snacks
  • Birthday Parties
  • Art Classes
  • Field Trips
  • Holiday Parties

I wish that this 504 Plan was available when my son attended school! Do not forget to check your school's ruling on peanut butter. A lot of schools will not allow lunches to contain peanut butter because of severe peanut allergies, and we need to be respectful of other food allergies as we sort through the maze of gluten-free lunch packing.

If you have a picky eater or a child who needs to gain weight after their diagnosis, nutritional shakes, power bars and calorie powders can pack a punch. Make sure they are labeled gluten-free. Consult with a registered dietitian to help with your child's meal plan. When you find a winning combo, send enough with your child to share. That will show your child's peers that gluten-free food is not "weird" and your child will have the opportunity to feel part of the group.

Recently, the U.S. Department of Agriculture (USDA) mandated that food service workers who manage and handle meals would need to complete education and training requirements in order to maintain their positions. The requirement to maintain professional standards education, which is required by the Healthy, Hunger-Free Kids Act, went into effect on July 1, 2015. Completion of the GREAT Schools program helps school nutrition professionals meet this requirement. You can remind your child's school that completing the GREAT Schools training program does benefit both your child and the cafeteria staff in maintaining the necessary education to work in school food service

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I went into menopause at age 42. I didn't know I had celiac until I was 56. Now I know why my menopause was so early.

Have been dealing with splinter hemorrhages on three of my toe nails since February. I did go to my doctor who rightly so did a very complete blood work-up ruling out other diseases such as lupus and RA and referred me to several other doctors to make sure that it was not cancer, endocarditis, or something serious. I went to the doctors. I have done some research on vitamin deficiency and it seems that some link splinter hemorrhages to vitamin C deficiency. For the past 2 1/2 weeks I have been eating 3 clementines a day (in addition to the usual multivitamin that I take) and it seems to be helping the splinter hemorrhages. One has grown out and not returned. Visited my GI doctor today and talked about malabsorption of nutrients as a potential issue. We are doing more blood work and checking nutrient levels. I have to believe it has something to do with the celiac. Sorry I don't have a better answer, but like you am trying to figure this out. Please let me know if you find any answers, and yes, be sure to check with your doctor to rule out anything serious.

You only need one positive on the celiac panel. I tested positive only to the DGP IgA and had a Marsh Stage IIIB intestinal damage. Good luck!

Welcome to the forum. First, you need to get copies of your celiac test to confirm you actually had it done and what the results were. Second, to confirm a diagnosis, you must obtain biopsies via an endoscopy. Were the doctors gastroenterologists? Third you need to research celiac disease. Yes, you can be asymptomatic, but could still have instestinal damage as the small intestine is vast. here is a good place to start: http://www.cureceliacdisease.org/screening/ You might think you are a silent celiac, but ever been anemic? Had your bones checked?

That's good to know about Texas Children's, unfortunately I don't believe they accept our insurance. Our former pediatrician joined with one of their medical groups and we had to find a new one due to insurance. I'll check out their site though.