Managing Childhood Asthma in the School Environment

It is often taken for granted that schools are instrumental in the spread of illness from child to child as well as from child to teacher. In addition to the nagging colds, stomach viruses and other temporary maladies, the school environment may actually contribute to some lifelong medical conditions. Many children face an unhealthy school environment on a daily basis, year after year, which may contribute to a condition called asthma. Asthma causes the airways of the lungs to swell and constrict and can often flare up without warning. Asthma is one of the top childhood disorders and is also a leading occupational disease of teachers and custodians. Many hours are spent in the classroom setting and over time this assumed ‘safe’ setting can turn into a “sick classroom” affecting those who are most vulnerable. The focus of this article is to examine the effects of asthma on school age children and provide information to empower teachers to facilitate change in the classroom environment. Working together with parents and administrators, teachers can make changes that will reduce asthma triggers and thereby reduce and possibly prevent severe asthmatic episodes. Classroom teachers and other school personnel are responsible for providing an educational atmosphere where students have the opportunity to fulfill their potential in academics. This is a challenge when students are faced with breathing difficulties in the classroom setting. These breathing or respiratory difficulties may be cold, flu, or allergy related, but often the problem is asthma. Asthma is one of the most prevalent and serious lifelong diseases in children. This essay will discuss the rising prevalence of asthma and what school personnel can do to make the classroom a more productive learning environment for school age children with asthma. Childhood Asthma Asthma is a chronic airway inflammatory disease, often arising from allergies, characterized by bronchospasms that subsequently cause shortness of breath, wheezing and coughing. Due to swelling, the air is restricted from passing easily through the bronchioles and makes it hard for a child to breathe. These flare ups are also called asthma attacks or exacerbations. Asthma affects children in different ways. Some children have asthma attacks only during allergy season, when they breathe in cold air, or when they exercise. Other children have more severe attacks that require a physician’s intervention due to the continuous inflammation underlying the asthma. There are important warning signs that indicate when a child’s asthma is not in proper control. According to the American Lung Association, these signs include: needing to use a quick relief inhaler more than two times per week, waking at night with asthma symptoms more than two times per month, or having to refill a quick relief MANAGING CHILDHOOD ASTHMA 34 inhaler more than two times per year (American Lung Association 2010, May 4). Asthma rates in children are reaching epidemic proportions, adversely affecting children’s quality of life and educational potential (Levy, Heffner, Stewart, & Beeman, 2006). In the United States, an estimated nine million children have asthma and more than four million children had an asthma attack within the previous year. Childhood asthma accounts for approximately 200,000 hospitalizations and 658,000 emergency department visits annually in the United States (Camargo, Jr., Ramachandran, Ryskina, Lewis, & Legorreta, 2007, p. 1054). This disorder is the third leading cause of hospitalization among children under the age of 15. Asthma afflicts children of all ages, races, and ethnic groups but “has a disproportionate effect on low-income minority children who reside in large urban areas” (Nelson, Awad, Alexander, & Clark, 2009, p. 210). “African American children are four times more likely to be hospitalized and five times more likely to die from asthma than Caucasian children” (Lee, Jackson, Parker, DuBose, & Botchway, 2009, p. 5). In 2009, there were approximately 14.4 million lost school days in children with asthma (American Lung Association, 2010). These lost days not only affect the education of the individual children but the school systems as well. Accreditation and state funding for schools are directly correlated to attendance, therefore increased absences have a negative impact on funding (Moonie, Sterling, Figgs,