Reviewed by Ann Mullen, RN, CNS, AE-C, CDE, TTS

School-Age Children and Asthma

Download the printable School Asthma Action Plan (pdf).

Asthma is the most common pediatric lung disease. It affects about one in ten children. This means asthma effects children in school. Children with asthma have swollen (inflammation), sensitive airways that lead to episodes of trouble breathing. Although there is no known cure for asthma, it can be controlled. When asthma is under good control, the inflammation and obstruction in the airways will be decreased. Because children spend most of their day at school, it is important that school personnel understand asthma and asthma management in school. This handout introduces asthma management concepts and gives school personnel detailed information about this student's asthma management program.  This is often called a school asthma action plan. Managing asthma will make it possible for the child to participate in school to the level of their ability.


What Makes Asthma Worse

Asthma triggers are the things that make asthma worse right away or slowly over time. Every child with asthma has different asthma triggers. Things that make asthma worse should be avoided or controlled in the school environment. Things that can make asthma worse include: irritants (e.g., smoke and fumes), allergens (e.g., furry animals, grasses and trees), exercise, infections and emotions. Although emotions may make asthma symptoms worse, they do not cause asthma.

Many children with asthma may use a metered-dose-inhaler before exercise to prevent asthma symptoms during exercise at school.


Asthma Symptoms

Early warning signs and asthma symptoms are indicators that a child's asthma may be getting worse. Monitoring asthma signs and symptoms is helpful in managing asthma at school. Signs and symptoms are things that children feel or that you may notice when asthma is getting worse. Common symptoms to watch for include: coughing, shortness of breath, chest tightness and/or wheezing.


Peak Flow Monitoring

In addition to watching for asthma symptoms, some children with asthma may monitor their breathing at school by using a peak flow meter. A peak flow meter measures the flow of air in a forced exhalation. Peak flow monitoring can help identify the start of an asthma episode, often before the child is having symptoms. Peak flow zones divide the peak flow meter into the colors of a traffic light and can help children and school personnel make decisions about asthma management.
  • Personal Best:

  • Green Zone (All Clear) Above:

  • Yellow Zone (Caution):

  • Red Zone (Medical Alert) Below:


Asthma Medications

Asthma medications are divided into two groups: long-term control and quick-relief medications. Some quick-relief medications (e.g., Proventil®, Ventolin®, ProAir®) work quickly to relax the muscles around the airways. These are used to treat asthma symptoms.  They may also be used as a pre-treatment before exercise. Long-term control medications are used daily to maintain control of asthma and prevent asthma symptoms. Long-term control medications may be inhaled (e.g., Flovent®, Pulmicort®, QVar®, Advair®, Dulera®. Symbicort®, or oral (e.g., Singulair®). Children often use these at home.  Most children use a combination of long-term control and quick-relief medications to manage their asthma.

Spacers or holding chambers are devices that attach to the inhaler to increase the amount of medication that is delivered to the child's airways. Many children may use these.

Download the printable School Asthma Action Plan (pdf).


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