Growing Up with Asthma: Transitioning to Elementary School

Asthma is a chronic lung condition that affects people of all ages, including young children. In fact, most children who have asthma develop symptoms before the age of five. However, at this age it can be very hard to diagnose which is why parents need to carefully monitor symptoms and work closely with their healthcare providers. Once a child becomes school age, management can become even more challenging. But the upcoming school year can be a positive and healthy experience for your child when you have the right plans in place.

Managing Asthma for Toddlers

Infants and toddlers can be difficult to diagnose with asthma because they are unable to communicate as well as older children. It is also challenging to diagnose young children because they are sometimes too small for a lung function test. In this case, your child may be diagnosed with reactive airway disease (RAD) before receiving their asthma diagnosis. Regardless, proper treatment is especially important because these young children have much smaller airways and even a small blockage can make breathing difficult. For children who attend daycare or other preschool classes, this can be troubling as these classrooms are breeding grounds for the flu, RSV, COVID-19 and other respiratory illnesses.

Treating children with asthma who are five and younger takes high awareness and patience. Most children at this age are extremely active, so even if they are experiencing trouble breathing it can be hard to recognize symptoms. Adults should look for nostrils flaring, exaggerated belly movement and panting, wheezing and coughing. Fortunately, preschool teachers usually have smaller classes, with about eight to 10 children to each caretaker, so hopefully, they are more able to recognize a child struggling with asthma symptoms. Be sure to inform your child’s teacher of their symptoms and what to look for.

Treatment does not always look linear. Your young children’s lungs are maturing and changing so if their asthma has been identified and is being treated, their medication may change as they mature. This is why you should always closely monitor your child’s asthma symptoms and document your child’s episodes so that you can work with your healthcare provider to create an Asthma Action Plan. Your healthcare provider will need to know:

• A family history of asthma, allergies and any other chronic condition
• Any abnormal breathing symptoms, noting for instance, when the child is active vs. at rest, nighttime vs. daytime, difficulties breathing when sick and response to any medications
• New and current asthma or allergy triggers
• Once the child is old enough, the results of a lung function test, blood tests, allergy testing or X-rays will help make a correct diagnosis

Elementary School Asthma Management

For young students and their families, moving from preschool to kindergarten is a crucial time, particularly if the student has been diagnosed with asthma. Entering kindergarten signifies the beginning of elementary school and new experiences such as new indoor and outdoor environments, teachers and students. Class sizes become larger with less teachers per student, and the buildings and grounds increase. This means additional triggers will be present with more of an opportunity for children to have an asthma flare-up without notice from an adult.

Families and students moving to elementary school will want to work with the school staff and your healthcare provider to navigate this process. This includes scheduling a wellness-check with the child’s healthcare provider. At this appointment the physician will want to determine how controlled your child’s asthma is, and if changes need to be made to medications to keep their asthma well managed. This is also a good time to update your child’s asthma action plan, so that you can present it to the school.

Talking directly with the school and district staff is the best way to ensure that everyone is prepared for the school year. The American Lung Association’s Back to School with Healthy Lungs guide provides key information about working with your child's school and managing your child's asthma during the school year. Start by contacting the school about your child’s asthma and allergies through a written note, asking for an in-person meeting. Together with key personnel like the school nurse, primary teacher or even the principal, you can create a school healthcare plan, which lists your child’s possible triggers, common symptoms, essential and rescue medicine and what to do if they have a flare-up.

Teaching Asthma Management to Your Child

Transitioning into elementary school is a great time to begin getting your child involved in their own healthcare. This means educating them as best you can about their asthma so that they begin to recognize their symptoms and learn to seek out an adult for assistance. Some other ways you can help them minimize trigger risks is to encourage practicing good hygiene. Teaching your child to wash their hands properly and cover their mouth and nose when sneezing or coughing is a good start for asthma management even at a young age.

As your child continues to mature, talk to their healthcare provider about when they will be old enough to self-carry and take their medicine on their own. Taking small steps to help them learn how to manage their asthma will make it easier when they make another big life transition, to college.