PARENTS TYPICALLY MAKE two common errors when a child has asthma.

First, they don't recognize the symptoms. Yet who would think that a persistent cough or frequent respiratory infections could signal asthma? Often, even physicians don't pick up on the signs until a child has suffered with the problem for years.

The second error happens after diagnosis. Many well-intentioned parents hold back giving their child medications as prescribed since they assume — incorrectly — the cure could be worse than the condition. As a result, children don't get the care that would allow them to breathe well and engage in normal activities with friends and schoolmates.

Christy Olson, R.N., B.S., M.S., admits it took her time to climb the learning curve. "Even though I was a nurse at the time, I know I undermedicated my children because I was fearful of giving them all that medicine. It's a common theme among parents," she says.

Today Olson is helping to set things straight as a nurse educator with the Fairfax, Va.-based Allergy and Asthma Network/Mothers of Asthmatics. A certified asthma instructor, she answers questions on the AANMA's Web site and staffs the organization's toll-free helpline.

Not only do both of her children have asthma, but Olson herself developed the chronic lung condition as an adult. Her advice to other parents of children with asthma follows.

Empower Yourself
Learn everything you can about asthma, Olson urges. "For me, knowledge was my power tool. The more I learned, the more comfortable I became. And the more comfortable I was, the more my children became comfortable in knowing I was doing the right thing for them," she says.

About 20 million people in the United States have asthma, and an estimated 6.3 million of them are under age 18, according to the Centers for Disease Control and Prevention. Asthma is the leading serious chronic illness among children and the top reason children miss school for a chronic condition, according to the American Lung Association.

Common symptoms include recurring episodes of coughing, wheezing, chest tightness and shortness of breath.

Any child who has frequent coughing or respiratory infections, such as pneumonia or bronchitis, should be evaluated for asthma. If asthma is diagnosed, parents need to work closely with their family physician to develop an action plan for their child. Most children have mild to moderate symptoms that treatment can control.

"Make sure your child's asthma is under control, because if it is, he or she can do anything any other child can do," says Olson.

Treatment includes sticking with the prescribed medication regimen, while avoiding or controlling the things that trigger asthma.

Common triggers include:

• Exercise
• Respiratory infections
• Allergies to pollen, mold, animal dander, foods or other substances
• Exposure to irritants, such as tobacco smoke, strong odors, fumes or cold air

Empower Your Child's School
One might think educators would know how to deal with asthma in children, but teachers, administrators and gym instructors often know surprisingly little.

Olson arranged a group meeting at the start of each school year to review her child's treatment needs with teachers, coaches, the administration and the school nurse. This was a must, she explains, because her daughter's asthma attacks often came on quickly and required a swift response.

In the meetings, Olson would discuss:

• General asthma information
• What could trigger asthma in her child
• The importance of pre-treating exercise-induced asthma before physical activity
• Where to store emergency medications at school for quick access
• How to use asthma equipment in case of an emergency
• Responsibilities of both her daughter and the staff regarding her carrying her own medication inhaler at school
• How to cover the child's needs during field trips

Empower Your Child
Children can play a key role in asthma management, depending on their age and maturity. They can learn how to avoid their triggers, keep medications on hand and self-administer them. Older children should be as responsible as possible for their own treatment, many experts advise.

"I do a lot of problem-solving with my daughter," says Olson. "Asthma is an insidious disease, and symptoms can arise when you least expect it. It's important to not let your guard down."

Emotions are another tough issue, especially when a child has chronic symptoms. "My daughter was chronically sick for about a year and a half. Her classmates would make fun of her because of the plan she had to follow at school. She wanted to be like everyone else," Olson says. The best way parents can support a child through difficult times is to be relaxed and open about asthma, its symptoms and its treatments, and to give clear guidance to other responsible adults.

"If teachers are aware, they can help resolve some of the stigma by addressing peer pressure," says Olson. In addition, their awareness will be a boon for other children with asthma.

All empowerment begins with your awareness, Olson adds. "I believe educating yourself about asthma is the best gift you can give your child," she says.

Polly Turner spoke with Christy Olson, R.N., B.S., M.S., a nurse educator with the Allergy and Asthma Network/Mothers of Asthmatics (AANMA). For more information, call the AANMA toll-free at 800-878-4403, or visit www.aanma.org.

Resources for Children With Asthma

• KIDS' ASTHMA CHECK. This simple online questionnaire can help pinpoint a potential asthma problem in a child. Visit http://allergy.mcg.edu/
  patients/index.html and click on "Kids' Asthma Check" (choose the link for "Ages 1-8" or "Ages 8-14").
• ASTHMA CAMPS. Children attend daylong or weekend camps where they can swim, hike and do arts and crafts while learning how to manage their asthma symptoms. Visit www.asthmacamps.org to learn more or to locate a camp near you.
• ASTHMA AND ALLERGY FOUNDATION OF AMERICA. Visit www.aafa.org or call 800-7-ASTHMA for answers to your questions about asthma in children.
• ASTHMABUSTERS. This free online asthma education program for children ages 7 to 14 is sponsored by the American Lung Association and operates annually from January through April. Included: monthly online magazine and fun challenges that help children manage their asthma while earning prizes. Children must have permission from a parent or guardian to register. Visit www.asthmabusters.org.
• ASTHMA & PHYSICAL ACTIVITY IN THE SCHOOL. This excellent, readable booklet is a must-read for teachers and coaches. Download a copy at www.nhlbi.nih.gov/health/public/lung/asthma/
  phy_asth.htm or order a copy by credit card for $2.50 by calling 301-592-8573.
• JUST FOR KIDS. Fun learning activities for children with asthma are on the Web site of the American Academy of Allergy, Asthma & Immunology. Visit www.aaaai.org/patients/just4kids/default.stm.

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