Asthma and Learning Readiness

What is asthma?  

Symptoms of Asthma in Children

• An audible whistling or wheezing when your child exhales 
• Coughing, especially if the cough is frequent and occurs in spasms 
• Waking at night with coughing or wheezing 
• Shortness of breath, which may or may not occur when your child exercises 
• A tight feeling in your child's chest 

From "What is Asthma," MayoClinic.com.  (Not available in Spanish)

The “A, B, C’s” of Asthma Challenges

One reason your child may not be able to meet the challenges of school is that he/she simply can’t breathe. For asthmatic children, asthma presents learning challenges. If a child is having difficulty breathing, the focus of the child’s energies will be on breathing and not on the lessons at hand. It is estimated that nationally, approximately 10 percent of schoolchildren may have asthma. One study reported the absence rate is three times higher among children diagnosed with asthma.

“A” is for Attendance — A basic necessity of learning starts with “A” as in attendance. The American Academy of Allergy and Immunology states that, “Going to school with asthma introduces two sometimes opposing realities. The first reality is that uninterrupted daily attendance at school maximizes a child’s chances to learn and provides the student with the continuity of instruction necessary to reach his or her potential. The second reality is that asthma is a largely unpredictable disease, and it often interrupts learning by distracting [the child] or keeping children away from school.”

“B” is for Behavior — Asthma has an impact on the social and emotional, as well as, the physical health of a child. A child may feel “different” because he/she has to sit down during playtime, or avoid touching the classroom pet because it may trigger an asthma attack. Or the child may feel embarrassment over having to take his/her medication in front of peers. Anxiety is also common among children who may be experiencing difficulty breathing. Children who are being emotionally challenged are less likely to engage actively in the learning process. 

A child's participation in the learning process will be impacted if they are having difficulty breathing. The medications prescribed to assist the child’s breathing also may cause behaviors that can limit a child’s participation in the learning process. Fatigue or drowsiness simply can be the result of a sleepless night caused by coughing. Asthma medications can cause side effects such as nervousness, nausea, jitteriness, hyperactivity, and inability to concentrate. Any one of these issues can pose a significant barrier to learning. There is, however, some good news. 

“C” is for Control, but not Cure — At this time, there is no cure for asthma. Fortunately, new ways of controlling asthma and managing it long-term are available. It is possible to reduce asthma’s personal, social, and economic burdens. Children with asthma can live normal lives in which the disease has a minimal impact on their daily activities and learning progress. Children with asthma need proper support in their learning environment to keep their asthma under control and be fully active. Head Start, schools or child care staff, health professionals, and parents can work together to remove obstacles and to promote students’ health and education.

Components of Asthma Management 

There are four components of a school-based asthma management program: 

Asthma-friendly policies include providing access to a school nurse. Another asthma-friendly policy is that every child with asthma will have a written, physician-directed asthma management plan on file. This plan should include a strategy to manage chronic and worsening symptoms, a list of medications to be taken and instruction on when and how to take them, measures to prevent exercise-induced asthma attacks, and a list of known asthma triggers. The third asthma-friendly policy is that every school/child care would have an asthma action plan. This plan is different than the asthma management plan in that it directs staff action in an asthma emergency. An asthma attack can be a life-threatening event. Anyone who may have to care for a child under these circumstances needs to know what the policies require. Does staff know what to do? Who to call? When to call, etc.? Some of these answers can come through a staff asthma management training program.

Healthy Environment — Since children spend most of their time in school, child care facilities, or at home, it is important to reduce their exposure to environmental asthma triggers as much as possible in each of these environments. Many indoor air quality problems in schools can impact the health of students and staff, including those with asthma. Follow the link to the right for more information.

Asthma Education — Schools/child cares have a “duty to care" that is shared by all staff members. This duty arises because children need to be at school (or in a child care setting), away from their usual sources of protection (parents). This duty may require administering medication, monitoring health status, providing specialized staffing or training to staff, and protecting students from emotional distress. As a result, all faculty and staff should, as a matter of policy, participate in asthma management training. Of course, every child who has asthma should know about his/her condition and how to manage it (the level of knowledge, of course, will vary depending on the age of the child). In addition, other children in the school (or child care) should know something about asthma.   

Communication — The final component of an asthma management program is perhaps the most important, communication. The asthma management team includes the child, parents, Head Start/school/child care staff, and the child’s physician. Parents and staff should monitor the child’s learning, absenteeism, and the facility environment. Any changes in the child’s symptoms or behavior should be communicated to the other team members. If all members of the asthma management team are monitoring the child’s behavior and communicating with the other team members, we can achieve optimal asthma control and enhance the child’s learning opportunities.

In summary, asthma problems can’t be solved in the school/child care environment alone, but together, we can make a difference. Successful asthma management means that children with asthma can live active, healthy lives. There is a clear connection between health interventions and student success.

See the checklist to complete before you see your physician:

• Facts About Controlling Your Asthma

Additional Articles/Resources

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National Asthma Education and Prevention Program — The NAEPP works with intermediaries including major medical associations, voluntary health organizations, and community programs to educate patients, health professionals, and the public. 

Idaho Asthma Prevention and Control Project; Asthma Coalition of Idaho

How Asthma-Friendly Is Your School?
(¿Su escuela tiene en cuenta a los niños con asma?)

How Asthma-Friendly Is Your Child Care Setting?
(¿Su guardería infantil tiene en cuenta a los niños con asma?)

® American Lung Association