Asthma and the School-Age Child

Help for the Asthmatic Child

How are kids impacted in school?

Asthma is responsible for the over 10 million school absences each year and plays a vital role in the life of school-age children. Attacks may flare up unexpectedly, resulting in children refraining from playing school sports, missing class to take their time-sensitive asthma medication, and carrying around the insecurities associated with having this illness.

Studies show that children aged 5 to 17 with severe asthma were three times more likely to have serious behavioral problems and learning disabilities than other children. Many of these disabilities result from drug-related side effects that might also influence school performance. The more you understand asthma – the symptoms, causes, and treatments – the better prepared you will be to help improve the quality of life for you and your child.

What is Asthma?

Asthma occurs when the airways swell and air passages in the lungs narrow, making breathing difficult. Those with asthma react to environmental triggers, including dust, dust mites, mold, or pets. Reactions to these factors induce asthma attacks resulting in wheezing and/or coughing symptoms, which can be fatal.

During an asthma attack, the mucus-producing cells within the airway increase their output, causing mucus to plug the airway. Parts of the airway become entirely blocked with the combination of airway narrowing, mucus plugging, and airway inflammation. Air becomes trapped in the alveoli (air sacs at the end of the bronchioles.) Proper exchange of oxygen and carbon dioxide cannot be provided for when air is trapped, leading to hypoxia (low oxygen content) in the body.

Identifying the Symptoms

Young children exhibit different signs of asthma than adults, making it difficult for doctors to distinguish between asthma and infections. Asthma in children may appear as rapid respiration, noisy breathing, chest retraction, and congestion. According to the National Asthma Education and Prevention Program, wheezing is the number one indicator of childhood asthma. Wheezing occurs mainly when your child exhales and results from air moving through a narrow airway, causing airflow turbulence and noisy respiration. You should notice whether your child has less stamina during active playtime than other children or whether your child limits physical activities to prevent coughing or wheezing.

Recurrent or constant coughing spells indicate that your child may suffer from asthma. Chronic coughing is worse during the evening and nighttime hours and could last for months. Ancillary allergies that may be associated with asthma include hay fever, food allergies, hives, and eczema. Documenting your child’s symptoms is the best evidence you can give your child’s doctor to determine the appropriate treatment.

What to Expect in an Asthma Diagnosis

Now that you know the symptoms, you are in a better position to validate whether you think your child is an asthma sufferer or not, but the real test should be done by a doctor. Since asthma is harder to pinpoint in children than in adults, your child’s doctor will ask personal questions. Talk to your child in advance about being honest with their doctor and give the child some personal time to chat with his or her physician, if necessary.

Three essential components of an asthma diagnosis include:

• Conduct a detailed medical history of the family and the child. Asthma is a hereditary disease, often passed down through generations, so the more the doctor knows about the entire family’s history, the better off your child will be.
• Conducting a physical check-up. You can be sure that your child’s doctor will conduct a thorough physical examination, including laboratory testing, to determine the cause of their asthma.
• Lung function

Listening to your child’s rhythmic breathing and checking out their lungs will give the doctor a head starts in determining treatment.

Physical Side Effects

Severe effects of asthma may include loss of elasticity of the lungs due to air trapping and low oxygen, called “airway remodeling.” Children may not grow as well because of the body's long-term trapped air and low oxygen content. Asthma also causes irritability and fatigue. Asthma is neither a contagious nor a psychological disease but can cause depression and despair.

Scientific studies show that bronchial inflammation is present in all asthmatics, even if they do not exhibit the symptoms. Not recognizing the severity of the symptoms places children at a higher risk due to delayed treatments, so the more prepared you are to deal with asthma, the lower the risk category your child will be in. Although asthma is a chronic disease, it can be controlled with the right treatment plan. Recognizing the symptoms and following the treatments is the first step to a healthier childhood.

A Child’s Perception of Themselves – Dealing with Asthma

Peer pressure and self-image are two of the biggest pressures on kids today. Childhood and teenage years are filled with anxiety, developing responsibility, friends, peer pressure, and self-image. So how do you communicate to your child that dealing with asthma does not make them different, that they are probably not the only child in the school with an inhaler in their backpack, and that asthma is nothing to be ashamed of? A child’s search for independence can impact their asthma management, not to mention having a concerned parent constantly reminding them to take their medication. Getting a child intricately involved in asthma management is key to compliance.

Get all the information you can on asthma, and have your child completely understand what is happening inside their bodies. The more they know, the more prepared they are to protect themselves against triggers and the more accepting they will be of their disease. Ask your child if they have other friends with asthma they can talk to. Friends can also be helpful in warding off asthma attacks by knowing what substances trigger your child’s asthma, such as cigarette smoking, perfumes, or after-shaves. Kids spend much of their time encompassed in school and after-school activities. Friends can help if your child has an attack. Be sure your child informs fellow peers where their medicine and physician’s phone number are kept, what to do in case of an attack, and whom to call. Using an inhaler at school may be embarrassing, but children are less likely to cringe by telling friends why they use it and how it helps them.

Eventually, your child may be confident to expose that inhaler before their peers. You may be the most significant factor in protecting your child at school by informing their teachers, coaches, and the school nurse of all the vital information necessary to prevent and/or treat an attack. This information includes phone numbers, medication information, physical limits, and your child’s known triggers.

Time Out

It only takes five minutes of jogging or running in the schoolyard for your child to start coughing, have shortness of breath, or wheezing, particularly in cold weather. As many as 10 percent of school-aged children experience the symptoms of exercise-induced asthma. Caused by any form of physical activity, signs of exercise-induced asthma include intense breathing during physical activity, causing water loss in the lungs, which leads to cooling of the lung lining and constriction of airway muscles. The problem is worsened by cold and dry weather. Children should know that symptoms peak between eight to 15 minutes after exercise ends and resurface hours later. Peak-flow measurements should be taken before and after exercise; poor measurements may indicate that your child should participate in less strenuous activity and that his or her asthma needs better control so it does not limit activities. Simply resting up to 15 minutes after an attack may allow symptoms to disappear.

If you know your child has exercise-induced asthma, make sure you have a management plan on file at the school. Taking medication before exercising often prevents attacks, and repeating the dose during an exercise period may be necessary. Warm-up and cool-down measurements have also been shown to help reduce attacks. Exercise is an essential element in living with asthma. Physicians view exercise as an essential component in helping asthma sufferers strengthen their bodies and well-being – because an active body is healthier. Studies show that the psychological benefits of exercise are just as significant as the physical benefits. Higher self-esteem, increased feelings of competence, and a sense of normalcy are some health benefits of full participation in age-appropriate physical activities.

With the various medications and monitoring technologies now available, asthma rarely stops any child from exercising or participating in any form of athletics. For a child’s optimal control, paying close attention to how their body reacts to physical activity is the key to controlling their asthma on the field and off. Keep an open relationship between you and your child and educate school officials and students about asthma. It is still possible for children to enjoy a normal lifestyle, including daily sports activities, ensuring they have access to their medication when necessary. Alternative exercises like sitting on the sidelines are not cool, even in the medical industry. Doctors’ orders for children with asthma are to find an exercise regime that augments a child’s well-being while still controlling the associated asthmatic triggers of sports.

Simple pleasures such as bicycling and swimming are excellent ways to get in a good workout and improve asthma's effects on the body. Studies prove that a regular exercise program using the century-old bicycle improves cardiovascular breathing while raising inner and outer strength, positively impacting a child’s self-esteem. Swimming, known as a low-level, high-energy booster for years, also limits the triggers associated with sports-induced asthma. The combination of a warm pool and low humidity makes this a perfect exercise for asthmatics. Swimmers can take their time while exercising, stop when necessary, and feel great after their workout.

Follow Doctor's Orders

Your child’s doctor should be aware of any new endeavors your child has planned, including jobs, sports, and vacations. Be sure your child follows their doctor’s management plan and keeps open communication with their doctor.