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This information was reviewed and approved by Flavia Hoyte, MD (2/6/2023).

School-Age Children and Asthma

Download the printable School Asthma Action Plan (pdf).

Asthma is the most common pediatric lung disease. It affects about 1 in 10 children. This means asthma affects children in school. Children with asthma have swollen (inflamed), 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. The school asthma action plan introduces asthma management concepts and gives school personnel detailed information about this student's asthma management program. Managing asthma will make it possible for children to participate in school at their best.

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 attack, 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.

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 pretreatment 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.

Meet with School Staff 

Plan a meeting with school staff before or in the beginning weeks of the school year. It is helpful to have the school nurse, health aide, teacher and physical education teacher at the meeting. Your child also can be involved in the meeting. Take the written Asthma Action Plan to the meeting. Review the Asthma Action Plan, asthma symptoms, use of the peak flow meter, medicines and things that make your child's asthma worse.

Special School Supplies for Asthma

Keep a spacer and rescue medicine at school for your child. If your child uses a peak flow meter at home, you may want to keep one at school also. Be sure your child's teacher knows that the medication is there should a problem arise. Make sure the rescue medicine has not passed its expiration date. Take these items home at the end of each school year.

Gym Class

Make sure your child has a pretreatment for gym class or other physical activities, especially outdoors in cold weather. It is important to be sure that all teachers know this medication is to prevent problems or to take care of them if they should occur.

Field Trips

Asthma should not keep your child from participating in an off-site field trip. Be prepared to take medicines along to use for asthma flare-ups. Trips to the zoo or a farm can be a bad experience if medications are not available.


Medication Side Effects

Studies have shown that asthma medicines typically don't cause concentration problems. However, a child who receives high doses of medicine during an asthma attack may experience side effects, such as restlessness and trouble concentrating. If you or your child’s doctor are giving increased doses or new medications, alert your child's teacher.

Keep in Touch

Continue talking with your child and school staff about managing asthma at school on a regular basis, even if everything is fine at school. Talk with the school staff if your child misses school and assignments. If your child is up at night with asthma symptoms, let the teacher know. Your child may be tired and having trouble concentrating the next day at school.

When to Stay Home

Talk with your child's doctor about when it is okay to stay home from school because of asthma or illness. Mild asthma symptoms can usually be handled at school, but there are a number of factors (what triggered the asthma, the stability of asthma symptoms and peak flows, fever, how much medicine your child is taking, etc.) to consider when deciding whether to keep your child at home.


Download the printable School Asthma Action Plan (pdf).


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