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Dr. Ken Shore's
Classroom Problem Solver

Dealing With
A Student with Asthma

Asthma, an illness in which the airways that carry air into and out of the lungs become inflamed, is the most common chronic childhood illness. The disease affects about one child in 20, so on average, teachers will have one student with asthma in every class.

Asthma is not contagious, so it cannot be passed from one student to another, but it can cause a student to miss much class time. In fact, it is the primary illness-related cause of school absenteeism. Children with asthma are absent from school three times as often as children without asthma. In addition, their frequent trips to the school nurse lessen their time in the classroom. Even when they are in class, these students might have difficulty focusing on classroom lessons. The asthma symptoms and accompanying anxiety can hinder concentration on schoolwork, and asthma-related sleeping problems can cause sleepiness in class. As a result, you might find that a student with asthma has trouble following directions or keeping up with class work.

Asthma also can give rise to emotional difficulties. Children with asthma can become discouraged by the medical demands of the illness, the frequent attacks, the physical discomfort, and the days spent at home. They might feel different from their peers, and you could see signs of withdrawal or low self-esteem. In providing a "safety net" for a student with asthma, you need to walk a fine line. You want to give him emotional support without accentuating his difference. If asthma is managed effectively, the student need only be minimally affected and can participate in almost all school activities.

WHAT YOU CAN DO

Talk with the school nurse about your school's asthma policy. The nurse should be able to tell you the policy for students' taking asthma medication in school. The American Academy of Allergy and Immunology recommends that "students with asthma be permitted to have in their possession inhaled medications for the treatment and prevention of asthma symptoms when they are prescribed by that student's physician." Although elementary school students might need supervision to ensure that medication is taken properly, most middle and high school students are capable of carrying and regulating their own medication.

Talk with the parents. At the beginning of the school year, you and the school nurse should gather information from the parents about how to manage their child's asthma in school. Even if you are knowledgeable about asthma, you still will need to learn about this student's asthma profile because asthma is different for each person. You might want to inquire about medication and inhaler issues, particular asthma triggers, physical restrictions, and strategies for managing an attack.

Develop a written asthma management plan customized to the student. This management plan, which should include contact information as well as the factors listed above, should be an outcome of the meeting with parents and should be tailored to the child's particular needs. The student's teachers and others in school who work with him also should be aware of the plan.

Speak with the student individually. Talk with the student privately to reassure him that you are aware of his asthma and know what to do if he has an attack. Let him know that he can go to the nurse when he feels an attack coming on or when he feels tired and needs to lie down. Suggest a signal that he can give to you to let you know that he is leaving class.

Educate your students about asthma. Ask the parents and student for permission to talk with the class about asthma. You might want to invite the parents and student to participate in the discussion. Describe for students what an asthma attack is and what they are likely to see. Let them know that it is important that they stay calm and that the student will get better once he takes his medication.

Monitor the child's understanding of lessons and assignments. The asthma symptoms might cause the student to have problems paying attention in class, which could cause him to miss directions and have difficulty completing class work. Check up on him periodically to make sure he is aware of what he needs to do. Consider assigning a responsible student to sit next to him and help him stay on track.

Provide opportunities for the child to make up missed work. This can be a particular problem in high school. You need to develop clear procedures for how the student will make up work and communicate those procedures to the parents. You might arrange for the parents to pick up the work, have it sent home with another student or a sibling, or give it to the parents over the phone.

Try to eliminate asthma triggers from your classroom. Take the student's parents on a tour of your classroom when school is not in session so they can help you identify possible asthma triggers, which might include animals with fur, chalk dust, rugs, science projects with plants or flowers, or new paint.