Almost five million children below the age of 18 suffer from asthma. Increasing in incidence, asthma is the most widespread chronic disease of school-aged children. The disease is responsible for 10.1 million school absences each year — three times as many as any other cause. Asthma is also able to reduce attendance at school athletic programs. Nevertheless, when appropriately managed, children suffering from asthma can fully attend both academic and athletic aspects of student life.
Children suffering from asthma can’t leave their illness at home just like that. They need to keep in mind their symptoms whenever or wherever they appear. Due to the fact that children spend a lot of time at school, asthma normally influences their lives there. For instance, children may have to take medicines in during school time or take special preventive measures in order to avoid attacks. Moreover, the side effects of these medications may affect their school performance, and the stress of living with a chronic illness may leads to many psychological problems that play out at school. Asthma attacks induced by physical activity exhibits its own set of problems for gym class and other exercises. Hence, it is extremely significant that the child, family, school and healthcare professionals communicate on a regular basis and that they all work together to keep the child’s asthma under constant control.
Due to medical confidentiality issues, it is up to parents (not the physicians) to inform the school that their child suffers from asthma. Your healthcare provider may have a form letter that can be used to do this. When the school year starts, it may be helpful to meet with the teachers at school who will be working with your child and review your child’s medical information. Teachers, the school nurse and other school staff have to be advised about any medicines that your child takes, including potential side effects, what to do if a medication has to be taken within school hours, when to keep a child inside, when it may be required to excuse him or her from gym, when a visit to the school nurse may be necessary, and when a parent should be contacted. The school nurse should be in possession of a written copy of your child’s complete treatment plan for asthma, and all medicines should be clearly labeled.
Some communities have used schools to teach the public about asthma, both to screen children for undiagnosed cases of asthma and to inform school workers of the role they can play in helping children suffering from asthma achieve success in school. All children suffering from asthma ought to be able to live their lives as normally as possible. Programs such as the Open Airways curriculum in New York City and the Awesome Asthma School Days program in Milwaukee and others like them have been successful in increasing familiarity with asthma and helping children suffering from asthma control their disease.
Below you have several issues that the Journal of School Health says schools should address to give children suffering from asthma the appropriate support and create an asthma-friendly school:
* Keep schools smoke-free, not only within school hours but also at all after-school events.
* Maintain good indoor air quality at school, decreasing or even eliminating allergens and irritants when possible.
* Have a school nurse on duty or on call every day.
* Establish reasonable policies for children to take medicines in school.
* Have an emergency plan for handling serious asthma attacks, including whom to call and when.
* Teach the school personnel and students about asthma.
* Ensure that students suffering from asthma have safe options for attending physical education class and recess, including access to their medicines when needed.
School personnel and students also have to be familiar with asthma induced by physical activity, asthma "attacks" that happen when someone is practicing sports. Ten percent of school-aged children suffer from the symptoms of asthma induced by physical activity at some time or other. Even though the precise cause of this disease is unknown, intense breathing in the course of physical exertion may lead to water loss in the lungs, resulting in cooling of the lining of the lungs and narrowing (constriction) of airway muscles, which, in turn, may cause difficulty breathing. It may be worsened by cold, dry weather. In the majority of cases, symptoms peak eight to fifteen minutes after finishing exercise, and then begin to improve. Children will be breathing normally soon after, however symptoms may reoccur several hours later.
If you know that your child suffers from exercise-induced asthma, be sure that you have a management plan on file at the school. (If you suspect that your child may experience this condition, contact your child’s physician in order to discuss your concerns.) Frequently, taking medicines before physical activity prevents attacks. It may be required to repeat the dose in the course of an exercise period. Taking time to warm-up and cool-down also has proven to be helpful in reducing the number of attacks. For some children, peak-flow measurements need to be taken before and after physical activity. Poor measurements may suggest that the child ought to attend a less exhausting activity and that his or her asthma requires better control so it does not reduce activities. With the variety of medicines and monitoring technologies that are currently available, it happens very seldom that asthma has to stop any child from physical activity or participation in any form of athletics.
Parents, healthcare professionals, teachers and other school staff also should be prepared to the possibility of emotional and/or behavioral problems in children suffering from chronic asthma. Some research has confirmed a connection between severe asthma and serious behavioral problems.
