Celiac Disease and Child Behavior: Unmasking the Hidden Drivers of Irritability and Misconduct in the Classroom

Dear Colleagues,

Celiac disease (CD) is well recognized as an autoimmune enteropathy with clear gastrointestinal and nutritional consequences, yet its behavioral and emotional dimensions in childhood remain critically underexplored in both clinical and educational settings. Undiagnosed or poorly managed CD can manifest as irritability, anxiety, inattention, aggression, depression, and other conduct concerns that surface most visibly at school. These signs are often interpreted strictly as discipline or mental health issues, leaving the biological trigger unaddressed.

This Special Issue targets not only medical researchers and clinicians but also the front-line professionals and caregivers who directly shape a child’s day-to-day environment: teachers, school administrators, school psychologists, and parents. Educators witness behavioral fluctuations firsthand, parents must advocate for accurate evaluation, and administrators determine district-level policies—yet all may lack accessible information linking CD to classroom behavior. School psychologists, while often responsible for identifying patterns of emotional or behavioral concerns, are not permitted to name or discuss medical conditions such as CD during eligibility or consent meetings due to professional boundaries. As a result, important medical red flags may be overlooked or remain unaddressed in educational evaluations.

We invite contributions examining how CD influences mood dysregulation and attention deficits in children, how gut–brain and nutrient pathways shape student behavior, and how misread symptoms delay diagnosis.

Topics may include, but are not limited to, the following:

• Emotional and behavioral dysregulation in children with undiagnosed or untreated CD;
• The role of nutrient deficiencies in cognitive and behavioral symptoms;
• Misdiagnosis risks—when celiac-related symptoms resemble ADD, anxiety, depression, or other conduct disorders;
• Gut–brain axis disruptions in children with CD—clinical and behavioral implications;
• Sleep disruption, fatigue, and their impact on school functioning in children with CD;
• Challenges and barriers to identifying celiac symptoms in the educational setting;
• Professional limitations and referral pathways—the school psychologist’s role in recognizing potential CD;
• Parent perspectives and advocacy in navigating diagnosis and educational support;
• Educational interventions and accommodations for students with CD;
• Interdisciplinary collaboration between educators and healthcare professionals for early identification.

We welcome articles explicitly pitched to teachers, principals, district health coordinators, or family audiences that help translate findings into concrete action.

By assembling contributions from gastroenterology, pediatrics, psychiatry, nutrition, education, and family advocacy, this Special Issue seeks to advance both scientific understanding and practical implementation. Together, we can ensure that biological realities are recognized alongside behavioral observations, empowering educators, parents, and clinicians to support every child’s well-being and academic success.

Dr. Fatima E. Terrazas-Arellanes
Guest Editor

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• celiac disease
• child social-emotional behavior
• gut–brain axis
• emotional dysregulation
• school psychology
• nutrient deficiencies
• educational settings
• misdiagnosis
• gluten-free diet
• early diagnosis