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Harvard Commentaries
Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School

Asthma, Children And School

July 19, 2014

Asthma, Children And School
Asthma, Children And School
Asthma is the most common chronic illness of school-aged children. Find out what you can do to help your child and what issues schools should address to provide an asthma-friendly environment.
InteliHealth/Harvard Medical Content

Nearly 9% of children younger than 18 have asthma. Asthma is a common chronic illness of school-aged children. It also is the most common reason for school absences. Asthma can limit participation in school athletic programs. However, when properly managed, children with asthma can participate fully in both academic and athletic aspects of student life.

Children with asthma can't just leave their illness at home, and they must pay attention to their symptoms whenever or wherever they occur. Because children are in school many hours a day, asthma usually affects life there. For example, children may need to take medications during school or take special preventive measures to avoid attacks. In addition, drug side effects may influence school performance, and the stress of living with a chronic disease may cause psychological problems that play out at school. Exercise-induced asthma presents its own set of problems for gym class and other physical activity. Therefore, it is important that the child, family, school and health care providers communicate regularly and that they all work together to keep the child's asthma well controlled.

Because of medical confidentiality issues, it is up to parents (not health care providers) to inform the school if their child has asthma. Your doctor may have a form letter you can use for this purpose. At the beginning of the school year, it is helpful to meet with the people at school who will be working with your child and review your child's medical information. Teachers, the school nurse and other school personnel need to be advised about any medications your child takes, including possible side effects, what to do if a medication needs to be taken during school hours, when to keep a child inside, when it may be necessary to excuse him or her from gym, when a visit to the school nurse may be required, and when a parent should be called. The school nurse should have a written copy of your child's complete treatment plan for asthma. This is often called an Asthma Action Plan. All of your child's medicines should be clearly labeled.

Some communities have used schools to educate the public about asthma, both to screen children for undiagnosed cases of asthma and to inform school personnel of the role they can take in helping children with asthma succeed in school. All children with asthma should be able to live their lives as normally as possible.

Here are seven issues that the Journal of School Health says schools should address. These will help support children with asthma and create an asthma-friendly school:

  • Keep schools smoke free, not only during school hours but also at all after-school events.
  • Maintain good indoor air quality in the school, reducing or eliminating allergens and irritants when possible.
  • Have a school nurse on duty or on call every day.
  • Establish sensible policies for children to take medications in school.
  • Have an emergency plan for handling severe asthma attacks, including whom to call and when.
  • Educate the school staff and students about asthma.
  • Ensure that students with asthma have safe options for participating in physical education class and recess, including access to their medication when necessary.


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