Asthma: The Focus Is on Control


While asthma is the most common chronic disorder in children and a top reason children miss school, the medical community disputes the notion that asthmatic kids must stay inside and cannot run or jump or play like other kids.

Asthma is a chronic inflammation of the lungs that can make it difficult to breathe. With proper management, children and adults with asthma can live a long life without restrictions. Nevertheless, “it’s important to remember that asthma can be life-threatening if it’s not managed,” says Deborah Brown, acting CEO of the Mid-Atlantic office of the American Lung Association.

Speaking from her Wilmington, DE office, Brown describes asthma as a complex disease, with no single cause to pursue for a cure. As a result, in recent years the medical focus has been on controlling asthma rather than curing it. Because of asthma’s numerous triggers and reactions, individualized management is key.

Asthma Action Plan

The first step in management is an asthma action plan. The action plan is developed by your child’s doctor, and provides a written guide that helps parents to recognize symptoms and use medications properly.

“Asthma is a confusing disease for families,” says Dr. Tyra Bryant-Stephens, director of the Community Asthma Prevention Program at Children’s Hospital of Philadelphia. The action plan provides reassurance to parents that they’re giving medicines at the right time, the right way. As with most diseases, asthma attacks are easier to control if caught early. The goal is to treat the symptoms of asthma before a full attack occurs.

More Frequent In Philly

Asthma occurs more often in the Northeast corridor than in other parts of the U.S., and more often in Philadelphia than in surrounding counties.

The Numbers:

  • 22.8% of Philadelphia children up to age 17 have asthma.
  • 15.1% of kids in surrounding Pennsylvania counties have asthma, according to the Public Health Management Corp.

Dr. Tyra Bryant-Stephens of Children’s Hospital of Philadelphia says possible reasons for the city’s higher rate include:

  • Air pollution
  • Pests
  • Living in close proximity


There are two main types of asthma medications: long-term medicines that prevent chronic symptoms such as coughing and breathlessness, and quick-relief medications that treat asthma attacks as they occur. The long-term drugs are usually anti-inflammatories that reduce swelling of the airways to prevent attacks. The fast-acting drugs are mainly brochodilators that relax the muscles around the airways during an asthma attack.

At School

Parents of kids with asthma should meet with the school nurse at the beginning of the school year, recommends Madeline Mills, school nurse at Evergreen Avenue Elementary School in Woodbury, NJ. That way, parents and school staff can review the asthma action plan and be prepared if a problem occurs during the school day.

“The ultimate goal is to get kids to recognize symptoms before they get out of hand,” says Mills. Younger kids must visit the school nurse for asthma medications, but depending on each school district’s policy, middle and high school students can often self-medicate at school with their parents’ permission.

Mills advises parents and students to take basic steps before each school day to reduce stress, a trigger for asthma attacks:

  • Get a good night’s sleep.
  • Eat breakfast.
  • Be prepared academically.

At Home

Medical experts say these measures can reduce the risk of triggering asthma attacks at home.

  • Remove carpeting, where possible.
  • Purchase furniture that can be wiped down.
  • No furry pets. Regardless of how much or how little they shed, it’s their dander that triggers problematic reactions. If you are unable to give up your furry pet, make sure to bathe him frequently.
  • Keep humidity low.
  • Rodents, cockroaches and mold can also trigger attacks.
  • Dust can be a big trigger. While it is common in every home, do everything you can to remove “dust catchers.” Focus first on the bedroom, advises Dr. Bryant.

Stephens, where common dust collection culprits include books, toys, blinds and mattresses. She recommends covering the mattress and storing books and toys in a container.

For More Info

  • American Lung Association
  • EveryoneBreathe, a new website for parents of children with asthma, features a downloadable Asthma Action Plan; a checklist of questions for doctor visits; an Asthma Diary to record peak flow readings, asthma symptoms and medicines to bring to physician appointments; and a Caregiver Checklist to share with other caregivers when parents are not around.
  • KidsHealth Asthma Center

Suzanne Koup-Larsen is a contributing writer to MetroKids.


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