An Essential Handout For Teachers & Aides

January 12th, 2016

By Mary Fry, Diane Gallant, and Moira Giammetteo

What is the gluten-free, casein-free, soy-free (GFCFSF) diet?

This is a dietary intervention to lessen the digestive, bowel, and behavioral issues sometimes found in children with autism spectrum disorders (ASD). Recent research indicates a link between autism and gastrointestinal issues, which can include difficulties digesting gluten, casein, and soy proteins. Eliminating gluten (wheat), casein (milk and milk products), and soy often alleviates gastrointestinal problems, although additional factors often must be addressed as well (intestinal yeast overgrowth, for example). The GFCFSF diet may be considered an “alternative” therapy and viewed with skepticism by some school administrators, medical personnel, and others. But for some children, eliminating gluten and casein helps lessen self-stimulating behaviors, increases focus, and resolves gastrointestinal distress. That’s why many parents swear by it.
The diet is not a cure for autism nor is it a substitute for educational or behavioral interventions. Rather, by making the child more comfortable, the GFCFSF diet helps the child become more receptive to learning and makes a positive impact on the child’s overall health, demeanor, and behavior.

What do the children eat?

Children can eat a wide variety of meat, chicken, eggs (although some are allergic to chicken eggs), fruits, and vegetables – anything that does not contain gluten, casein, or soy. In addition to wheat, gluten is also found in oats, barley, rye, and most processed foods. Gluten is in even in Play Doh, adhesive on stamps and stickers, and many hygiene products (and can be absorbed through the skin; gluten does not need to be ingested to negatively affect a gluten-sensitive child). Casein is found in every milk product, and is even used as a binder in canned tuna fish and lunch meats.
Many children who are on the GFCFSF diet will react to the slightest bit of gluten, casein, or soy. A single bite of a goldfish cracker may cause a week of bad stools, aggressive and disruptive behavior, rashes, or other physical symptoms. A child who uses regular Play-Doh may become non-compliant, withdrawn, and regress. One bite of a graham cracker could result in severe tantrums, head-banging, and unusually strong, aggressive behaviors, sometimes lasting several days.
It’s also worth noting that some children may have additional food intolerances and sensitivities, including corn, rice, potatoes, peanuts, tree nuts, etc., and parents may request that other foods be eliminated.

How is the GFCFSF diet implemented at school?

The Individualized Education Plan (IEP) team will need to document that a dietary intervention is being used in conjunction with traditional interventions. Generally, the parents are responsible for providing GFCFSF supplies for their child to use in the classroom as well as any snacks or treats. Lunches may be provided by the parents or the school cafeteria. Teachers and aides must make sure that the child uses only the GFCFSF supplies provided and that food is not shared during snack or lunch times. Students in upper grades and beyond should be encouraged to learn about the diet and the consequences of infractions (i.e., painful diarrhea, loss of emotional control, etc.).

Does the school have to follow the diet?

Yes. Federal law says that the school must provide allergen-free foods at no additional costs to children whose disability restricts their diet, as defined in USDA’s nondiscrimination regulations (7 CFR Part 15b), and that all school staff must follow the child’s dietary needs specified in the IEP. The school is responsible for protecting children; negligence by staff may necessitate a 1:1 aide to keep the child safe in the school environment.

What about non-food items like Play-Doh?

Play Doh contains wheat. There is some debate about whether gluten molecules can be absorbed through the skin; however, there is no doubt that younger children often put their hands in their mouths or even eat Play Doh. Crayola Model Magic can be used as a Play Doh substitute. Other non-food items that may include wheat are paints, markers, glue, glue sticks, paste, tape, makeup or face paints, sunscreens, some bandages, glue on envelopes, stickers, hand stamps, lotions, etc. (For example, a shopping trip to Trader Joe’s ended with stickers all over a child’s legs and arms. The child’s resulting aggressive behavior convinced the parents to avoid stickers on skin in the future.) The safest way to handle this is to provide parents with a list of items needed, and only use products sent from home. If the child becomes sunburned because the parent failed to send in GFCFSF sunscreen, that is the parent’s fault, not the staff’s. For crafts involving pasta, make sure that the parent supplies rice or corn pasta in the necessary shapes and quantities. Give them plenty of notice.

What about materials used in speech therapy, occupational therapy, and physical therapy?

Toothettes and lemon flavored cotton swabs used by speech therapists are GFCFSF. Parents can provide lollipops, Jet brand marshmallows, candy reinforcers, etc. as part of their school supplies. Check shaving cream ingredients before using them for occupational therapy, as some brands contain gluten. Beans and rice are fine in sensory integration bins. Beeswax, Model Magic or Silly Putty can be used for molding clays to improve hand strength. However, some substances—Nickelodeon Floam or Gak—are not GFCFSF. Lotions and powders used in physical therapy or for sensory integration should be provided by the parent after consultation with the therapist. (When in doubt, ask the parent to confirm GFCFSF status, or to provide a suitable substitute to be reserved solely for their child’s use.)

What happens when we have special treats for birthdays or holidays?

Teachers should give the parent a few days’ notice to provide alternative treats. Parents who are using the GFCFSF diet cannot easily run to the store to find diet-friendly cupcakes for the next day. Given enough notice, though, most parents can come up with substitutes. Try to make birthdays and holidays less food-oriented; substitute crafts, carnival or piñata toys, music, or movement activities for cookies and cupcakes. If you have a freezer on-site, you might ask the parent to provide a few cupcakes and cookies to freeze for unplanned celebrations, so that the child need not feel left out.

We have many hands-on activities that involve food - how should we handle this?

Give the parent at least a few days’ notice – the more the better – and start planning some alternate activities that do not involve food. Example: If the class is going to make a loaf of bread from scratch, ask the GFCFSF parent to supply the flours for the dough. Parents may be happy to do this once in a while, but if their child must be excluded from weekly pizza parties or daily snack preparation, teachers may hear complaints.

What should I do if the child eats or gets into something they shouldn't?

Call the parents as soon as possible for instructions – be prepared to tell them what the food was, the quantity, and the time that the incident occurred. Do not wait. Some parents may want to pick up the child or drive to school to give digestive enzymes or over-the-counter medications to minimize reactions. Inform the parents as soon as possible and try not to let it happen again.

Anything else?

It is critical to keep the lines of communication open. The GFCFSF diet can be challenging to follow, but with cooperation and knowledge, it is very manageable to maintain in the classroom. If parents and teachers work together, the improvements in the child’s health, language, social engagement, and behavior make this a win-win situation across the board.
No one says the diet cures autism – but it just may make traditional interventions go more smoothly for everyone concerned.

GFCFSF school supplies

  • Chalk: Crayola
  • Crayons: Crayola
  • Foam / Shaving cream: Colgate Shaving Cream is GF/CF (non-mentholated, white cream preferred)
  • Glue (liquid): Elmer’s washable glue or Ross
  • Glue Stick: Elmer’s or Ross
  • Markers: Crayola (including Color Wonder as well)
  • Paints (w/ brush): Palmer paint products; Crayola Oil Pastels, powder paint, and water soluble oil pastels; Prism Brand paints
  • Paints: Crayola Finger and powder paints, Palmer, Lakeshore or Prang.  Ross and Elmer’s paints (except finger paints)
  • Play Clay: Crayola Model Magic (NO Crayola Clay – that contains gluten)
  • Silly Putty: Crayola
  • Stickers (Most contain gluten; may be acceptable if placed on clothes or paper. However, if stickers are placed on skin, the adhesive is transferring gluten directly through the skin.): RoseArt brand stickers, Sandylion brand stickers, Smilemakers brand stickers
  • Tape: 3M brand tapes, including Post-It notes and Scotch tape

**Please contact manufacturers to verify GFCFSF status since they may change ingredients.

GFCFSF Personal Care Products

Any lotions or topical products used that are NOT GFCF can cause as much of a problem as eating a forbidden food.

  • Sunscreen – Banana Boat
  • Lip balm – Burt’s Bees Pomegranate or medicated balms

Reminder: If you are unsure whether a product is safe for a child on the GFCFSF diet, avoid it until you can confer directly with the child’s parents. Remember, companies modify their products from time to time, so it is wise to double-check the ingredients.

Including GFCF diet into the IEP goals & objectives

Here are some sample goals and objectives to include in your IEP.


Child will deny offer of foods that are not brought from home

Incremental objective #1 related to the goal:
When adult asks child if he can eat food not brought from home, he will answer "No" 70% of the time.

Incremental objective #2 related to the goal:
When adult asks child if he can eat food not brought from home, he will answer "No" 80% of the time.


Child will self monitor the consumption of safe foods and non-edible items

Incremental objective #1 related to the goal:
Will be able to decline offers of unsafe foods that look similar to his by asking "Am I allergic to this?" 2 out of 5 opportunities.

Incremental objective #2 related to the goal:
Will refrain from eating non-edible items (such as rocks, plastic and wood) at all times independently or by asking an adult 4 out of 5 opportunities.


Child will self-monitor safe food consumption (gluten and casein free diet)

Incremental objective #1 related to the goal:
Will be able to only consume foods provided for him from home.

Incremental objective #2 related to the goal:
Will be able to decline offers of unsafe foods.

NOTE: These are sample goals. Please be sure to work with your team of professionals in making a goal list that is unique to your child’s needs.


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