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Management of Asthma in Preschool Settings

written by: Dawn Salamon • edited by: Diana Cooper • updated: 3/11/2011

Asthma is one of the most common chronic childhood diseases and is the leading cause of absenteeism in school-age children. Find out why a management plan for asthma and preschool settings is necessary and how it can be successfully done.

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    Information and Statistics on Childhood Asthma

    Asthma is a chronic inflammation of the airways that temporarily narrows the air passages that bring air to the lungs, filling them with mucus and resulting in symptoms such as difficulty breathing, coughing, tightness in the chest and a "wheezing" sound. Asthma triggers include respiratory infections and colds; allergic reactions to allergens such as pollen, mold, animal dander, feathers, dust, dust mites, certain foods and pests; exposure to irritants such as cold air, perfumes and other strong odors, pesticides and cigarette smoke; and physical exercise, especially in colder temperatures.

    According to the 2009 National Health Interview Survey, approximately 10 million children have ever been diagnosed with asthma and 7.1 million children under the age of 18 currently still have asthma, making it one of the most common diseases affecting children. Also according to the study, boys were more likely to have ever been diagnosed with asthma than girls (17 percent vs. 11 percent) and African-American children were more likely to have ever been diagnosed with asthma or to still have asthma (22 percent and 17 percent) than Hispanic children (13 percent and 8 percent) or non-Hispanic white children (12 percent and 8 percent).

    Lastly, the American Lung Association says that for children under age 15, asthma attacks are the third most common cause of hospitalizations. In 2006, about 32.7 percent of all hospital discharges due to asthma were in children under age 15, even though only 20.1 percent of the U.S. population falls into that age group.

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      The Importance of Asthma Management in a Preschool Setting

      Asthma attacks are the number one cause of absenteeism in schools. According to the Environmental Protection Agency (EPA), approximately one out of every 10 school-age children currently has asthma and almost 13 million school days per year are missed due to an asthma attack. Also, children in the preschool-age group are being diagnosed with asthma at a higher rate than any other school-age group.

      Children suffering from uncontrolled asthma have worse attendance records and weaker academic performance than students without asthma, even at the preschool level. In the past, asthma management for children centered on treating the attacks as they occurred. Now, the focus has shifted to preventing attacks before they happen, specifically by minimizing the known environmental triggers that are typically found in schools (i.e., pests, mold, animal dander, dust mites and tobacco smoke), using asthma medications correctly, monitoring students who have asthma with a peak flow meter (if needed), recognizing the early symptoms of an asthma attack and intervening immediately with the necessary course of action.

      The idea of asthma and preschool settings may sound more ominous because of the young age of the students. But by developing and instituting a well-designed asthma management plan that is proactive instead of reactive, preschool teachers and students can expect:

        • Less absences due to fewer attacks and early treatment of symptoms.
        • Less disruption in the classroom due to fewer attacks and early treatment of symptoms.
        • A safer learning environment that understands the special needs of the students who have asthma.
        • School staff to administer the proper emergency care in the event of an attack according to established protocols.
        • Better participation rates in all physical activities and special events due to fewer attacks.

        Studies have shown that students with controlled asthma in conjunction with a good asthma management plan at school have attendance records equal to those students without asthma.

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        With a comprehensive asthma management plan, asthma can be managed successfully in a preschool setting. This article describes what the plan should include to help minimize attacks and keep preschoolers safe.
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        What Should a Preschool Asthma Management Program Include?

        In order for an asthma management program to be effective, it has to be a coordinated effort between the preschool staff, the parents of the students with asthma, and their attending physicians. A well-developed asthma management plan should have two components - a school staff management plan and a student asthma action plan.

        The school staff management plan should include:

        • A confidential list of all students who have asthma.
        • A written action plan for each individual student with asthma.
        • The policies and procedures for dispensing medications, emergency responses to a severe asthma episode, etc.
        • Each staff members' role in executing the asthma management program.
        • The available asthma education programs for both the staff and students.

        The preschool should request that the parents and/or guardians provide a student asthma action plan that was developed by their physician that details:

        • A complete list of medications the student receives, regardless of when taken, especially if school activities take place off-site or during non-school hours.
        • A specific action plan if an acute asthma attack occurs.
        • Known triggers that can worsen asthma attack.
        • Emergency contacts and phone numbers, including physician information.
        • Any other pertinent information regarding the student's asthmatic condition.

        By developing a comprehensive asthma management plan, a preschool can help reassure a parent that their child's asthma is well-monitored and the staff is capable of handling an attack, no matter the severity. Another way a preschool can reassure parents of an asthmatic preschooler is to ensure that school policy recognizes the importance of communication between the school and the family through avenues such as reaching out to the families to encourage participation in the asthma management plan and providing opportunities for the families affected to share in any decision-making concerning the school's policies and procedures regarding the plan.

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        References

        American Lung Association website, http://www.lungusa.org/lung-disease/asthma/resources/facts-and-figures/asthma-children-fact-sheet.html

        Centers for Disease Control and Prevention (CDC) website, "Summary Health Statistics for U.S. Children: National Health Interview Survey, 2009", http://www.cdc.gov/nchs/data/series/sr_10/sr10_247.pdf

        Centers for Disease Control and Prevention (CDC) website, http://www.cdc.gov/HealthyYouth/asthma/

        Environmental Protection Agency (EPA) website, http://www.epa.gov/iaq/schools/managingasthma.html#The%20Asthma%20Epidemic

        National Heart Lung and Blood Institute website, "Managing Asthma: A Guide for Schools (2003 Edition)", http://www.nhlbi.nih.gov/health/prof/lung/asthma/asth_sch.htm

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