U.S. Department of Health and Human Services

National Institutes of Health 

National Heart, Lung, and Blood Institute

U.S. Department of Education

Office of Safe and Drug-Free Schools

Managing Asthma

 A G u i d e f o r S c h o o l s

National Asthma Education and Prevention Program



Contents

Overview	 	 	 	 	 	 1

What Is Asthma?	 	 	 	 	 3

Develop an Asthma Management 		 	 	 5

Program in Your School	 

Actions for School Staff	 	 	 	 9

Connecting With the Community	 	 	 	 23

Asthma Education Materials	 	 	 	 27

Resources	 	 	 	 	 	 	 35
ii MANAGING ASTHMA: A GUIDE FOR SCHOOLS

Foreword

This guide was developed as a collaborative project between the National Asthma 

Education and Prevention Program (NAEPP) (coordinated by the National Heart, 

Lung, and Blood Institute [NHLBI]), U.S. Department of Health and Human Services 

and the Office of Safe and Drug-Free Schools, U.S. Department of Education. These 

agencies are working together because of the serious health and educational threats 

that asthma poses to our Nation’s children. In the United States, approximately 2 in 

15 children have been diagnosed with asthma before they reach 18 years of age. But, 

with proper treatment, asthma can be controlled. This booklet is intended to provide 

school personnel with practical ways to help students with asthma come to school 

each day healthy and ready to learn.

Asthma is a leading cause of school absenteeism. According to parent reports, students 

miss 14 million days of school each year due to asthma. By encouraging school 

personnel to recognize asthma as a chronic disease requiring ongoing care, we hope 

to improve school attendance and keep students in classrooms, where they can learn, 

instead of in the health rooms of their schools. Although asthma cannot be cured, 

it can be controlled. Schools can help by being supportive of students and staff with 

asthma; adopting asthma-friendly policies and procedures; coordinating services with 

physicians, school personnel, patients, and families to serve students with asthma; 

and providing asthma education for students and staff.

This guide is intended to assist schools that are planning or maintaining an asthma 

management program for their students with asthma. For further information, please 

contact the NAEPP through the NHLBI Health Information Center at (301) 592-8573 

or on the Web at http://www.nhlbi.nih.gov. By making our schools more 

“asthma-friendly,” we can ensure that no child is left behind.

Claude Lenfant, M.D.

Director

National Heart, Lung, and Blood Institute

U.S. Department of Health and Human Services

Eric Andell, J.D.

Deputy Under Secretary

Office of Safe and Drug-Free Schools

U.S. Department of Education
iii

National Asthma Education

and Prevention Program

School Guide Working Group

Lani S. Wheeler, M.D., F.A.A.P., F.A.S.H.A. (Chair)

Medical Officer, Division of Adolescent and School Health

Centers for Disease Control and Prevention

Annapolis, MD

L. Kay Bartholomew, Ed.D., M.P.H.

Associate Professor of Behavioral Sciences

University of Texas Health Science Center 

at Houston

Houston, TX

Rose Boehm, R.R.T., R.C.M.

Baylor Asthma and Pulmonary Rehabilitation Center

Dallas, TX

Mary Brasler, Ed.D., R.N.

Director of Programs

Asthma and Allergy Foundation of America

Washington, DC

Carol Constante, R.N., M.A., C.S.N., F.N.A.S.N.

Past President

National Association of School Nurses

Towson, MD

Ellie Goldberg, M.Ed.

Education Rights Specialist

Healthy Kids: The Key to Basics

Newton, MA

Brenda Greene

Director of School Health Programs

National School Boards Association

Alexandria, VA

Pamela Luna, M.S.T., Dr.P.H.

Health and Education Consultant

Riverside, CA

Shirley McCoy

Principal

Shrevewood Elementary School

Falls Church, VA

Jennifer Medearis

Safe and Drug-Free Schools Program

U.S. Department of Education

Washington, DC

Katherine Pruitt

Director, Best Practices

American Lung Association

Washington, DC

Gary S. Rachelefsky, M.D., F.A.A.P., F.A.A.A.A.I

Director, Allergy Research Foundation

UCLA School of Medicine

Los Angeles, CA

Martha Ryder

Allergy and Asthma Network/Mothers of Asthmatics, Inc.

Fairfax, VA

Diana Schmidt, M.P.H.

Coordinator

National Asthma Education and Prevention Program

Kim Smith, M.S.W.

Public Affairs Specialist

U.S. Environmental Protection Agency

Washington, DC

Virginia Taggart, M.P.H.

Health Scientist Administrator

Division of Lung Diseases

Jennie Young

Project Coordinator

National Education Association Health Information Network

Washington, DC

Paul Williams, M.D.

Clinical Professor of Pediatrics and Environmental Health

University of Washington School of Medicine

Seattle, WA

Linda Wolfe, R.N., M.Ed.

President

National Association of School Nurses

Georgetown, DE

Prospect Associates, Ltd.

Zoe Santiago-Font

Associate Partnership Leader

Teresa Wilson, M.P.H., R.N.

Senior Partnership Leader
iv MANAGING ASTHMA: A GUIDE FOR SCHOOLS

School Education Subcommittee

Lani S. Wheeler, M.D., F.A.A.P., F.A.S.H.A. (Chair)

American School Health Association

Martha Ryder

Allergy and Asthma Network/Mothers of

Asthmatics, Inc.

Gary S. Rachelefsky, M.D., F.A.A.P., F.A.A.A.A.I

American Academy of Pediatrics

Chris Brophy

American Alliance for Health, Physical

Education, Recreation, and Dance

Rose Boehm, R.R.T., R.C.M.

American Association for Respiratory Care

Tennille G. Brown

American Association of School Administrators

Katherine Pruitt

American Lung Association

Paul V. Williams, M.D.

American Medical Association

Karen Huss, R.N., D.N.Sc.

American Nurses Association

Pamela J. Luna, M.S.T., Dr. P.H.

American Public Health Association

Mary Brasler, Ed.D., R.N.

Asthma and Allergy Foundation of America

Robin Brocato

Head Start Bureau

Shirley McCoy

National Association of Elementary School Principals

Linda Wolfe, R.N., M.Ed.

National Association of School Nurses

Mary Vernon-Smiley, M.D., M.P.H.

National Center for Chronic Disease Prevention, CDC

Leslie P. Boss, Ph.D., M.P.H.

National Center for Environmental Health, CDC

Jennie Young

National Education Association Health Information

Network

Diana K. Schmidt, M.P.H.

National Heart, Lung, and Blood Institute, NIH

J. Patrick Mastin

National Institute of Environmental Health Sciences, NIH

Brenda Greene

National School Boards Association

Estelle Bogdonoff, M.P.H., C.H.E.S.

Society for Public Health Education

Jennifer Medearis

U.S. Department of Education

Kim Smith, M.S.W.

U.S. Environmental Protection Agency


Overview

This guide is intended to assist schools that are 

planning and/or maintaining an asthma management 

program. This guide provides followup steps for 

schools that currently identify students with asthma 

through health forms or emergency cards or plan to 

do so. It is designed to offer practical information 

to school staff members of every position.

Asthma is a leading cause of 

school absenteeism.

Asthma is one of the leading causes of school 

absence due to illness. Approximately 9.2 million 

children younger than 18 years of age have been 

diagnosed with asthma in their lifetime; 3.2 million 

or approximately 6 percent of children ages 5 to 17 

had an asthma episode (attack) in the preceding 

year (2001 NHIS data).* School staff members 

can play an important role in helping students 

with asthma manage their disease at school.

Why Be Concerned About Asthma

at School?

As the figure shows, about 3 students in a classroom of 30 currently have asthma. Uncontrolled 

asthma can result in reduced performance for 

the child with asthma and disruptions for the 

entire classroom.

Students with asthma can function to their maximum 

potential if their needs are met. The benefits to 

students include better attendance; improved 

alertness and physical stamina; fewer symptoms; 

and fewer restrictions on participation in physical 

activities and special events, such as field trips, 

and fewer medical emergencies. Schools and their 

staff can work together with parents or guardians, 

students, and health care providers to minimize 

risk and to provide a healthy and safe educational 

environment for students with asthma. Good health 

and safety are prerequisites to academic achievement.

* National Health Interview Survey, National Center for Health Statistics, National Center for Disease Control and Prevention, 2001.

Diagnosed with asthma in their lifetime.
 MANAGING ASTHMA: A GUIDE FOR SCHOOLS

What to expect from effective 

asthma management in school 

settings

Effective asthma management can lead to the 

following positive results:

• A supportive learning environment for 

students with asthma.

• Reduced absences—students have fewer 

episodes and symptoms are treated earlier.

• Reduced disruption in the classroom— 

students have fewer symptoms when they 

adhere to their asthma action plan 

(See page 5).

• Appropriate emergency care—school staff 

members know how to respond to emergecies.

• Full student participation in physical activities—

physical education (PE) instructors and coaches 

know how to prevent exercise induced asthma.

Information you need to plan and 

maintain an asthma management 

program

Responding to the needs of students with asthma 

in the school setting requires a comprehensive, 

coordinated, and systematic approach. This guide 

will help by providing you with the following 

information:

• Background information on asthma, including 

a brief definition of asthma and a list of common 

“triggers” or stimuli that cause asthma episodes.

• A description of ways to effectively manage 

asthma in schools.

• Strategies for developing an asthma management program for schools.

• Tips for developing strong partnerships between 

school staff, families, and physicians.

• A checklist of basic elements for a comprehensive school asthma management program.

• Action sheets for specific school staff, listing 

ways each person can reinforce implementation 

of an asthma management program.

• Sample outreach letters to families and physicians.

• Asthma resources, including a student asthma 

action plan, and other educational materials.

• A resource directory of organizations to contact 

for assistance.


Asthma is a chronic lung disease that affects the 

airways. Children with asthma have airways that 

are inflamed. Inflamed airways are very sensitive, 

so they tend to react strongly to things called 

“triggers.” Triggers are either allergy-causing 

substances, such as dust mites, mold, and pollen; 

or irritants, such as cigarette smoke and fumes 

from paint and cleaning fluid. When the airways 

react to a trigger, they become narrower due to 

swelling and squeezing of the airways by the 

small muscles around them. This results in less 

air getting through to the lungs and less air getting 

out. Symptoms of asthma include acute episodes of:

• Coughing

• Wheezing (a whistling or squeaky sound 

during breathing)

• Chest tightness

• Shortness of breath

Symptoms can vary in severity; they can be mild 

or moderate and affect activity levels, or they can 

be severe and life threatening.

Asthma triggers and symptoms vary from one 

person to another. Some children have asthma 

symptoms only occasionally, while others have 

symptoms almost all the time. With proper control 

of asthma, children should have minimal or no 

asthma symptoms.

Common Asthma Triggers

Although triggers that cause an asthma episode vary 

among individuals, there are several common triggers.

• Allergens such as pollen, animal dander, dust 

mites, cockroaches, and molds

• Irritants such as cold air, perfume, pesticides, 

strong odors, weather changes, cigarette 

smoke, and chalk dust

• Respiratory infections such as a cold or the flu

• Physical exercise, especially in cold weather

Effective Management Can 

Control Asthma

Asthma can be controlled with proper medical 

diagnosis and management. It cannot be cured.

With appropriate asthma care, students with 

asthma should have minimal or no asthma 

symptoms. When their asthma is managed 

effectively, they can safely participate in all 

school activities. New treatment approaches 

emphasize preventing episodes by using 

medication appropriately and by protecting 

the airways from exposure to the triggers 

that cause inflammation.

What Is Asthma?
 MANAGING ASTHMA: A GUIDE FOR SCHOOLS

In the past, asthma care focused on treating acute 

episodes. We now know that asthma episodes 

should be prevented to reduce long-term lung 

damage. Effective management of asthma enables 

students with asthma to maintain a normal activity 

level, prevents symptoms of acute episodes, and 

minimizes the amount of medications and medication 

side effects.

Managing asthma relies on:

• Taking medication exactly as prescribed. 

A person with asthma may need two types 

of medications. One type is used to relax 

the airways and is taken as needed when 

symptoms occur. The other is used daily 

to decrease the inflammation in the airways 

and prevent episodes from occurring.

• Monitoring students with asthma. A peak 

flow meter, which helps to keep track of 

how well air is moving through the lungs, 

is helpful for some patients with asthma. 

When the airways become narrow from 

inflammation, the peak flow measurement 

will be lower.

• Recognizing the early warning signs of asthma. 

These signs may include coughing, shortness 

of breath, and increased breathing rate.

• Avoiding or controlling triggers.

• Intervening with proper therapy when early 

signs are recognized.

• Forming a partnership among the student, parent(s) 

or guardian(s), the physician, and school staff. 

The school team plays an important role in helping 

students manage their asthma by providing 

support for development and implementation 

of an asthma management program.


Develop an Asthma Management 

Program in Your School

This action plan should be developed by a licensed 

health care provider or physician, signed by a parent 

and the physician, kept on file at school, and renewed 

every year. Because every student’s asthma is 

different, the action plan must be specific to each 

student’s needs. The asthma action plans included 

in this guide serve as examples that may be adapted 

to fit the needs of your school in gathering and 

sharing asthma management information among 

school staff, parents or guardians and physicians.

Developing an asthma management program 

shows that your school is responsive to the needs 

of students with asthma. By developing procedures 

and guidelines, the asthma management program 

ensures that staff knows how to help students with 

asthma. A management program should contain:

• A confidential list of students who have asthma.

• School policies and procedures for administering 

medications, including protocols for emergency 

response to a severe asthma episode.

• Specific actions for staff members to perform 

in the asthma management program.

• A written action plan for every student 

with asthma.

• Education for staff and students about asthma.

Student Asthma Action Plan

Schools should request that parents or guardians 

send a written student asthma action plan to school. 

This action plan should include daily management 

guidelines and emergency steps in case of an 

asthma episode. The plan should describe the 

student’s medical information and specific steps 

for responding to worsening asthma symptoms. 

The asthma action plan should contain:

• A list of medications the student receives, 

noting which ones need to be taken during 

school hours. Also, medications needed during 

school activities “off-site” and “off-hours” 

should be noted and available.

• A specific plan of action for school staff in case 

of an acute episode that includes guidance for 

monitoring peak flow.

• Identified triggers that can make asthma worse.

• Emergency procedures and phone numbers.
 MANAGING ASTHMA: A GUIDE FOR SCHOOLS

A strong family-physician-school partnership 

is essential for students with asthma. A strong 

partnership improves attendance and positive 

educational outcomes for students with asthma. 

School policies supportive of partnerships contain 

the following:

• Outreach to families to encourage participation

in managing students’ asthma at school.

• Professional development for teachers and 

staff to enhance their effectiveness in asthma 

management and their skills in communicating 

with families.

• Good communication among physicians, 

school staff, and families, such as an ongoing 

exchange of information, agreement on goals 

and strategies, and a sharing of responsibilities.

• Opportunities for families to share in decisionmaking regarding school policies and procedures 

affecting their children.

• Linkages with special service agencies and 

community groups to address family and 

community issues when appropriate.

Partnerships for an 

Asthma-Friendly School


How Comprehensive Is Your School 

Asthma Management Program?

From the list below, check off those basic elements that make up the school 

asthma management program that you already have in place at your school.

 Indentified staff person(s) to coordinate the program

 A confidential list of students who have asthma 

 School policies and procedures for administering medications, including 

protocols for emergency response to a severe asthma episode

 Specific actions for staff members to perform in the asthma 

management program

 Education for staff and students about asthma

 A written action plan on file for every student with asthma, including:

• A list of medications to be taken

• Steps for school staff to take in case of an asthma episode

• Identified triggers that can make asthma worse

• Emergency procedures and phone numbers

 A strong family-physician-school partnership

If there are gaps in the basic elements included in your current school asthma 

management program, or if you are looking for resources to enhance your 

current efforts, the following sections of this guide provide reference materials 

intended for use by school staff members in their asthma management efforts.

• Actions for School Staff, p. 9

• Connecting With the Community, p. 23

• Asthma Education Materials, p. 27

• Resources, p. 35

Managing Asthma Ac t i o n s f o r S c h o o l S ta f f

• Principal or School Administrator

• School Nurse

• Health Assistants, Health Aides, or Other Health Service 

Providers in the School

• Classroom Teacher

• Physical Education Instructor and Coach

• Guidance Counselor, Social Worker, and Psychologist

• Facilities and Maintenance Staff

Note:

Although all action steps outlined in the following section for various school staff members can 

contribute to the goal of improved asthma management at school, some actions may have greater 

impact than others. Therefore, an effort is made to list the actions for each staff member in order 

of relative priority. Ultimately, however, each school must decide which steps are most practical 

to implement and best meet the school’s own needs and circumstances. Every small step can 

make a difference.

Apparent overlap of some action steps across different staff positions serves as a means of 

reinforcing each other’s efforts and makes the point that the implementation of a coordinated 

asthma management program requires a cohesive team approach where each staff member 

shares in the overall responsibility. Ideally, a qualified school nurse should be part of the 

team which supervises or provides nursing care to a student in the school setting.

9
10 MANAGING ASTHMA: A GUIDE FOR SCHOOLS

Actions for the Principal 

or School Administrator

Help Children With Asthma and 

Their Families Manage Asthma

• Involve your staff in developing a school 

asthma management program. An effective 

program requires a cooperative effort that 

involves students, parents or guardians, teachers, 

school staff, and physicians. Many members 

of the school staff can play a role in maintaining

your school’s asthma management program, 

however, the principal or school nurse are the 

most instrumental in initiating and implementing 

the program.

• Work with school nurses, other medical 

professionals, and parents or guardians to 

develop a policy that ensures that medication 

administration is safe, reliable, and effective 

and, to the extent possible, allows students to 

self-administer medication. Consult State 

regulations and nursing practice acts to 

ensure appropriate professional standards 

for student care.

• Designate one person on the school staff, 

preferably the school nurse, to be responsible 

for maintaining students’ asthma action plans 

and for educating appropriate staff members, 

including teachers, about each student’s 

individual asthma action plan. Have a backup

plan for emergencies in case the designee is 

not immediately available.

• Provide health alerts and institute appropriate 

guidance for outside play designed to protect 

students from extreme temperatures, high 

pollen counts, and air pollutants that may 

affect asthma.

Teach Staff, Students, and Families 

About Asthma

• Make sure that staff members understand the

school’s responsibilities under the Individuals 

With Disabilities Education Act (IDEA), Section 

504 of the Rehabilitation Act of 1973, Title II 

of the Americans With Disabilities Act (ADA), 

and, where applicable, Title III of the ADA, 

which applies to nonreligious private schools. 

In addition, staff should be familiar with any 

applicable State and local legal requirements.

• Provide in-service programs for staff members 

about managing asthma and allergies. You may 

get assistance from your school nurse, your 

local pediatrician or specialist, or a local 

hospital or medical society. Other sources 

of information are the Allergy and Asthma 

Network/Mothers of Asthmatics (AAN/MA), 

the American Lung Association (ALA), and 

the Asthma and Allergy Foundation of 

America (AAFA).

• Develop and present an information program

for all students to make them aware of the 

symptoms of asthma. Involve the public health 

nurse and/or school nurse.

• Support and encourage communication with 

parents or guardians and health care providers 

to improve school health services.

• Arrange for the development of an asthma

resource file for parents or guardians, students, 

and school personnel.
11

Keep the Environment Clear of 

Asthma-Provoking Substances

• Work with maintenance staff and environmental 

health specialists to set and monitor standards

for school maintenance, humidity, ventilation 

and indoor air quality, mold, and dust control. 

Design and schedule building repairs, 

renovations, or cleaning to avoid exposing 

students and staff to fumes, dust, and other 

irritants. When possible, try to schedule painting 

and major repairs during long vacations or the 

summer months.

• Enforce smoking bans on school property.
12 MANAGING ASTHMA: A GUIDE FOR SCHOOLS

Help Children With Asthma and 

Their Families Manage Asthma

• Identify students with asthma by:

– Reviewing medical records and emergency 

information.

– Including questions related to asthma in 

the health history.

• Talk with teachers to help them become 

familiar with the needs of students who 

have asthma.

• Maintain an asthma action plan for every 

student with asthma. Include information on 

administering medications, monitoring peak 

flow, reducing triggers, and responding to an 

asthma attack. 

• Have an emergency backup plan for times 

you are not immediately available. File student 

asthma action plans in a location that ensures 

easy access in an emergency.

• Arrange for administration of medication 

in accordance with school policy and State 

mandates. Provide easy access to emergency

medications. Support self-administration 

when appropriate. Consult medical and State 

Nurse Practice Acts to determine the legal 

scope of practice for those providing nursing 

interventions and management.

• Use a peak flow meter to monitor daily 

management of asthma among students with 

more severe or difficult-to-manage asthma. 

In addition, a peak flow meter should be used 

during acute episodes of asthma—both to 

assess severity of an episode to determine 

action needed, and to assess response to 

medication during an asthma episode.

Look for Children With 

Uncontrolled Asthma

• Communicate with parents or guardians 

and health care providers (with parental 

permission) about acute episodes, if any, 

and about changes in students’ health status, 

and to track asthma control.

• Discuss situations of suspected undiagnosed 

or poorly controlled asthma with the students, 

parents, or guardians and suggest referral 	 	

	 to their physician for a proper diagnosis 

or a treatment update.

Teach Staff, Students, and Families 

About Asthma

• Educate all staff members about asthma and 

its potential impact on students’ health, safety, 

and school performance. Within confidentiality 

guidelines, talk to school staff about students 

with asthma and their unique needs. 

– Teach staff to refer students to you when 

symptoms or side effects are interfering 

with breathing or school activities. 

– Provide this information to parents or 

guardians and encourage them to take 

the student to see a physician. 

• Conduct in-service courses on asthma, and 

consult with staff to guide decisions about both 

appropriate school activities for students with 

asthma and the importance of full participation.

• Provide asthma education for students

with asthma to help them improve their 

self-management skills.

• Collaborate with parent teacher

organizations to offer a family asthma 

education program in school.

• Provide asthma education for the general

student body to encourage students to be 

supportive of classmates who have asthma.

Actions for the School Nurse
13

• Train health aides or school assistants, if 

appropriate, in proper Metered Dose Inhaler 

(MDI), Dry Powder Inhaler (DPI), and peak 

flow techniques; use of a nebulizer; and 

recognition of the signs and symptoms 

of acute asthma. 

Keep the Environment Clear of 

Asthma-Provoking Substances

• Help provide a safe and healthy school

	 environment for students with asthma, 

including off-hours and off-site school 

programming.

Note:

School health services managed by licensed school nurses are the most effective way schools can meet the 

needs of students with asthma for safe, continuous, and coordinated care in a safe environment. The school 

nurse’s care plan, the Individualized Health Plan (IHP), or an asthma action plan document a student’s 

health management needs and direct how those needs will be met at school. Check with your State Nurse 

Practice Act for guidelines on delegation of health care tasks.

School health services are a related service under the Individuals With Disabilities Education Act (IDEA), 

Section 504 of the Rehabilitation Act of 1973 (Section 504), and Title II of the Americans With Disabilities 

Act (ADA). School health services must be provided to individual students if indicated on the student’s 

Individualized Education Program (IEP) under the IDEA, or if deemed necessary in providing a free, 

appropriate public education to students who are covered by Section 504 and Title II of the ADA. Not 

all students with asthma are covered by the IDEA. Students who experience difficulty breathing at school 

because of asthma may have a disability under Section 504 and Title II, which may qualify them to receive 

services under these laws. With respect to students who are covered under one or more of these laws, the 

individual situation of any particular student with asthma will affect what services are legally required for 

that particular student. For more information about these laws, please contact the Office for Civil Rights 

at the U.S. Department of Education.
14 MANAGING ASTHMA: A GUIDE FOR SCHOOLS

Actions for Health Assistants, Health Aides, 

or Other Health Providers in the School

Help Children With Asthma and 

Their Families Manage Asthma

• Identify students with asthma by:

– Reviewing the medical records and 

emergency information of all students

– Asking questions related to asthma on 

the school’s health history forms

• Maintain (in coordination with the school 

nurse) an asthma action plan for every 

student with asthma. Include information on 

administering medications, monitoring peak 

flow, reducing triggers, and responding to an 

asthma attack. File action plans in a location 

that ensures easy access in an emergency.

Look for Children With 

Uncontrolled Asthma

• Communicate (in coordination with the school 

nurse) with the parent(s) or guardian(s) 

and health care provider(s) (with parental 

permission) about acute episodes, if any, and 

about changes in a student’s health status, and 

to track asthma control.

• Talk with teachers to help them become familiar 

with the needs of students with asthma. Encourage 

them to refer students with poorly controlled 

asthma to you. Use the warning signs presented 

in this publication. (See page 28.) When you 

suspect a student has poorly controlled asthma, 

notify the school nurse who will discuss this 

with the parents or guardians and encourage 

them to take the student to see a physician.

Teach Staff, Students, and Families 

About Asthma

• Collaborate with parent-teacher

organizations to offer a family asthma 

education program in school.

• Help to provide asthma education for all 

students and encourage them to be supportive 

of classmates who have asthma.

Keep the Environment Clear of 

Asthma-Provoking Substances

• Help provide a safe and healthy school

	 environment for students with asthma, 

including off-hours and off-site school 

programming.
15

Note:

School health services managed by licensed school nurses are the most effective way schools can meet the 

needs of students with asthma for safe, continuous, and coordinated care in a safe environment. The school 

nurse’s care plan, the Individualized Health Plan (IHP), or an asthma action plan document a student’s 

health management needs and direct how those needs will be met at school. Check with your State Nurse 

Practice Act for guidelines on delegation of health care tasks.

School health services are a related service under the Individuals With Disabilities Education Act (IDEA), 

Section 504 of the Rehabilitation Act of 1973 (Section 504) and Title II of the Americans With Disabilities 

Act (ADA). School health services must be provided to individual students if indicated on the student’s 

Individualized Education Program (IEP) under the IDEA, or if deemed necessary in providing a free, 

appropriate, public education to students who are covered by Section 504 and Title II of the ADA. Not 

all students with asthma are covered by the IDEA. Students who experience difficulty breathing at school 

because of asthma may have a disability under Section 504 and Title II, which may qualify them to receive 

services under these laws. With respect to students who are covered under one or more of these laws, the 

individual situation of any particular student with asthma will affect what services are legally required for 

that particular student. For more information about these laws, please contact the Office for Civil Rights 

at the U.S. Department of Education.
16 MANAGING ASTHMA: A GUIDE FOR SCHOOLS

Help Children With Asthma and 

Their Families Manage Asthma

• Consult with your school nurse or principal 

for updated policy and procedures for managing 

students with chronic health conditions, such 

as asthma, including managing medication and 

responding to emergencies, such as an asthma 

episode (attack).

• Know your role. Know how to easily access a 

student’s asthma action plan or have a copy of it 

in the classroom, maintained in a confidential 

manner. Review it with the student and his or 

her parent(s) or guardian(s) to determine if 

any classroom modifications are necessary and 

how to otherwise work toward the goal of the 

student’s full participation in class activities. 

Ask the student to tell you when he/she is 

experiencing any difficulty in breathing, 

and know what steps to take in case of an 

asthma episode. Don’t delay getting medical

help for a student with severe or persistent 

breathing difficulty.

• Develop a clear procedure with the student 

and his or her parent(s) or guardian(s) for

handling schoolwork missed if the student 

has episodes of illness or misses school.

• Report if a student’s symptoms are

interfering with learning or activities with 

peers. Possible side effects of medicine that 

warrant referral are nervousness, nausea, 

jitteriness, hyperactivity, and drowsiness.

• Alert school administrators, school nurses, 

and parent(s) or guardian(s) of changes in a

student’s performance or behavior that might 

reflect trouble with asthma. The vast majority 

of students with asthma are able to participate 

fully in the school program when their asthma 

is well managed.

• Encourage the student with asthma to

participate fully in physical activities.

Plan activities to allow for variations in 

stamina or tolerance for exercise, especially 

if the student is recovering from illness. 

Changes in weather conditions (hot, cold, 

breezy) and poor air quality (smoke, smog, 

pollen) often can aggravate asthma.

• Plan field trips and other activities in a way

that ensures students with asthma can fully 	 	

	 participate.

Look for Children With 

Uncontrolled Asthma

• Be alert for signs of uncontrolled asthma.

– Lingering cough after a cold

– Persistent cough during the day

– Coughing during the night or early in 

the morning

– Coughing, wheezing, chest tightness, or 

shortness of breath after vigorous physical 

activity or activity in cold or windy weather

– Low level of stamina during physical 

activity or reluctance to participate

– Coughing, wheezing, chest tightness, or 

shortness of breath even though the child 

is taking medicine for asthma

– Increased use of asthma medicine to 

relieve coughing, wheezing, chest 

tightness, or shortness of breath

• Advise the school nurse when you suspect 

poorly controlled asthma in a student, so 

that the school nurse can discuss the situation 

with his or her parent(s) or guardian(s) and 

suggest referral to their physician for a proper 

diagnosis or a treatment update.

• Be aware of students with asthma in your 

class or classes. Understand their triggers and

symptoms. Observe what seems to make them 

better or worse, and share your observations 

with the school nurse, who in turn may discuss 

the situation with parents or guardians as 

appropriate.

Actions for the Classroom Teacher
17

• Know the signs and symptoms of asthma 

and the early warning signs of an asthma

episode. (See page 28.) If you have concerns 

about a student’s health, communicate them 

to the principal and to the parent or guardian 

in coordination with the school nurse.

Keep the Environment Clear of 

Asthma-Provoking Substances

• Reduce allergens and irritants in the 

classroom to help students who have allergies. 

Common allergens and irritants that can make 

asthma worse in classrooms include chalk dust, 

animals, dust, and strong odors (colognes 

or perfumes, paints, pesticides, cleaners 

or deodorizers, and markers).

Teach Staff, Students, and Their 

Families About Asthma

• Educate all students about lung health and 

asthma so they will be more understanding 

and accepting of students with asthma. Involve 

students with asthma in the manner and to the 

extent they prefer. Some will request complete 

confidentiality; others may want to talk about 

their symptoms or management.

• Use the resources found in this document, 

including the Asthma Action Plan and the 

checklist, How Asthma-Friendly Is Your School?
18 MANAGING ASTHMA: A GUIDE FOR SCHOOLS

Actions for the Physical Education 

Instructor and Coach

Help Children With Asthma and 

Their Families Manage Asthma

• Follow the student’s asthma action plan; if 

indicated, follow premedication procedures 

before the student exercises. Know how to easily 

access the action plan. Consult with the school 

nurse for clarification.

• Be sure that the student’s medications are

available for exercise activities that take place 

away from school or after regular school

hours. This preventive medicine enables most 

students with exercise-induced asthma to 

participate in any sport they choose. 

• Warm-up and cool-down activities 

appropriate for any exercise will also help the 

student with asthma.

• Keep students’ quick relief medications

readily available. Even with precautions, 

breathing problems may occur. Learn the 

signs of severe distress and allergic reactions. 

Have an emergency plan. Don’t delay getting 

medical help for a student with severe or 

persistent breathing difficulty.

• Maximize participation and minimize the risks 

by establishing good communication among 

parents or guardians, students, health care 

providers, and school staff. Learn about the 

student’s asthma triggers and medication plan.

• Encourage exercise and participation in

sports for students with asthma. When asthma 

is under good control, most students with 

asthma are able to play most sports. A number 

of Olympic medalists have asthma.

• Encourage students with asthma to participate 

actively in sports, but also recognize and respect

their limits. Plan to adjust the type, pace, or 

intensity of activities during extreme weather, 

the pollen season, poor air quality, or when a 

student has allergy symptoms or a peak flow 

number lower than usual. Permit less strenuous 

activities if a recent illness precludes full 

participation.
19

Look for Children With 

Uncontrolled Asthma

• When you suspect poorly controlled asthma 

in a student, notify the school nurse who, 

in turn, can discuss the situation with the 

student’s parent(s) or guardian(s) and suggest 

referral to their physician for a proper diagnosis 

or a treatment update. Signs of poorly controlled 

asthma include: coughing, wheezing, chest 

tightness, or shortness of breath. Exercise is 

a common trigger for children with asthma.
20 MANAGING ASTHMA: A GUIDE FOR SCHOOLS

Help Children With Asthma and 

Their Families Manage Asthma

• Help make sure that students with asthma are 

treated the same as students without asthma, 

except to address asthma needs.

• Promote and encourage independence

and self-care consistent with the student’s 

knowledge, skills, and behaviors.

• Help the student resolve any issues related 

to school policies or practices and to his or 

her asthma management.

• Recognize that learning to cope with asthma,

as with any chronic illness, can be stressful. 

Teachers may notice low self-esteem, withdrawal 

from activities, or difficulty making up schoolwork. 

Counseling may help identify unnecessary 

stressors and help the student handle problems 

more effectively.

Look for Children With 

Uncontrolled Asthma

• Advise parents and guardians on behavioral

strategies that improve adherence to treatment 

for students with poorly controlled asthma. 

Encourage families with life stressors to seek 

case management services from their health 

care providers.

Teach Staff, Students, and Families 

About Asthma

Help school personnel understand that asthma is

an inflammation in the airways, not an emotional or

psychological disease. It is not “all in the student’s 

head.” Physical responses to strong emotions, such 

as laughing or crying, can trigger an acute episode, 

because rapid breathing mechanically irritates and 

constricts the inflamed airways. However, these 

emotions do not “cause” asthma.

Actions for the Guidance Counselor, 

Social Worker, and Psychologist
21

Keep the Environment Clear of 

Asthma-Provoking Substances

• Develop an Indoor Air Quality (IAQ)

Management Plan to identify, solve, and 

prevent IAQ problems, such as mold growth, 

improperly maintained ventilation systems, 

and chemical pollutants from science and art 

classes. If allergens from classroom animals 

and cockroaches or other pests are known 

to cause problems for students with asthma, 

include allergen control in your IAQ plan.

• Inspect the building regularly for signs of 

mold, moisture, leaks, or spills.

• Establish and follow a regular cleaning

and maintenance schedule to help minimize 

allergen and irritant levels in your school.

• Enforce smoking bans on school property.

• Schedule extensive building repairs, pesticide 

applications, renovations, or cleaning when

the building is unoccupied to avoid exposing 

students to fumes, dust, and other irritants.

Actions for Facilities and 

Maintenance Staff

Teach Staff, Students, and Families 

About Asthma

• Provide information to school staff, parents 

or guardians, and students about air quality

problems, and involve them in plans to reduce 

asthma triggers (such as mold and secondhand 

smoke) and allergens (such as cockroaches, 

dust mites, and classroom animals) if they 

are known to cause problems for students 

with asthma.

• Obtain a copy of the U.S. Environmental 

Protection Agency’s (EPA) Indoor Air Quality 

Tools for Schools Action Kit to help staff identify 

and learn ways to reduce or eliminate

pollutant sources in the school environment 

that may bring about asthma attacks. Other 

relevant EPA publications include:

– Pest Control in the School Environment: 

Adopting Integrated Pest Management

– Mold Remediation in Schools and 

 Commercial Buildings

Managing Asthma Co n n e c t i n g Wi t h t h e Co m m u n i t y

• Sample Letter to Parents or Guardians

• Sample Letters to Physicians

Note:

The sample letters on the following pages can 

be sent as is or modified to meet the particulars 

of your school. The purpose of the letters is to 

outline steps parents or guardians and physicians 

can take to partner with the school in facilitating 

good asthma management.

23
Letter to Parents or Guardians

(SCHOOL DISTRICT LETTERHEAD TO GO HERE)

Dear __________________:

The school team at _______________________________ school is looking forward to an excellent year for 

your child, ______________________.

Our School Asthma Management Program will provide the following health services:

• Access to the school nurse

• Help for students with asthma in following their asthma action plans

• Asthma education for all students in grade(s) ______

• Asthma in-service training for all school staff

• Indoor Air Quality (IAQ) Tools for Schools to promote a healthy environment

In order to provide the best possible school asthma management for your child, we request your assistance 

with the following:

Please

• Obtain an asthma action plan (a statement of your child’s treatment goals, medication and peak flow 

plan, and environmental risk reduction measures) from your physician. Please be sure guidelines are 

included for managing symptoms during special school or off-site events (recess, gym, outdoor play, 

field trips, parties, art class, etc.). You may use the attached form.

• Meet with the school nurse—before school entry and as needed—to explain your child’s condition, 

medication, devices, and environmental triggers.

• Submit the attached Medication Administration form for any medication that is administered 

in school. Please provide pharmacy-labeled medications, personally bring them to school, and 

keep them refilled as needed.

• Meet with teachers to setup expectations for maintaining communication and continuity 

during absences.

• Prepare your child. Discuss and rehearse the medication plan; discuss how to handle symptoms, 

triggers, food restrictions, and school policies.

• Keep the school staff up to date on any changes in your child’s asthma action plan.

• Keep your physician up to date on school services and supports for helping your child manage 

his or her asthma.

Thank you for working with us to assist your child.

Sincerely,

Principal (signature) School Nurse (signature)
Letter (Sample 1) to Physicians

(SCHOOL DISTRICT LETTERHEAD TO GO HERE)

Dear __________________:

The school team at _____________________________ school is looking forward to an excellent year for your 

patient, ______________________.

Our School Asthma Management Program will provide the following health services:

• Access to the school nurse

• Help for students with asthma in following their asthma action plans

• Asthma education for all students in grade(s) ______

• Asthma in-service training for all school staff

• Indoor Air Quality (IAQ) Tools for Schools to promote a healthy environment

In order to provide the best possible school asthma management for your patient, we request your assistance 

with the following:

• Complete the attached asthma action plan or provide comparable information on another form and 

return to us at school.

• Complete the attached medication administration form for any medications that may need to 

be administered in school and return it to us at school. (Students may self-carry and administer 

their quick relief medications if you and the parents or guardians indicate approval on the form).

• Inform us of additional patient needs.

• Assist us in supporting family priorities. Connect parents or guardians with each other, support 

groups, and resources such as the Allergy and Asthma Network/Mothers of Asthmatics (AAN/MA), 

the American Lung Association (ALA), and the Asthma and Allergy Foundation of America (AAFA).

Let us know if you need information on educational rights and responsibilities (Individuals with Disabilities 

Education Act [IDEA] and Section 504 of the Rehabilitation Act of 1973) for your patients.

We look forward to working with you. Thank you for your help.

Sincerely,

Principal (signature) School Nurse (signature)
Date ___________

Dear ______________________: [name of provider]

We are writing about your patient, _______________________________ Date of Birth __________.

The following information is being provided for your information and records.

 Missed _________ days in ___________ period of time, possibly due to asthma.

 Is not complying with asthma medication at school or the treatment plan you have provided.

 Is not participating in physical education because of symptoms related to asthma.

 Visits school health office frequently because of symptoms related to asthma.

 Has required emergency management of asthma (e.g.: 911, ER referral).

	 Our observations would suggest that this student’s asthma severity may be as follows 

(observations are circled on chart below).

Days with Symptoms Nights with symptoms Peak Flow % Normal

Severe Persistent Continual Frequent < 60%

Moderate Persistent Daily > 4 per month 60% to 80%

Mild Persistent > 2 per week 3 to 4 per month > 80%

Mild Intermittent ≤ 2 per week ≤ 2 per month > 80%

The family was asked to schedule an appointment with you. Parents have provided permission for us to exchange the student’s 

health information with you (attached or shown below). Please contact us if there are questions or concerns. Thank you!

If you feel it is appropriate, please help us with the following:

 Send an “Asthma Action Plan” (attached form), so we can assist with your management plan.

 Student has no Peak Flow Meter. Please prescribe one so that we may better assist with management.

 Please prescribe a “Spacer.” This student’s technique with an MDI was observed and is not adequate.

 An additional MDI _______________ (medication name) is needed at school for optimal availability/safety.

 Please reassess this child and his/her current medical regimen (see symptoms/severity above).

 Other ___________________________________________________________________

______________________________________________________________________

Sincerely,

District Medical Consultant (Signature) School Nurse (Signature) 

School: __________________________________ Phone: ( ____) _____________ Fax: ( ____) ______________

Best days/time to call: _______________________

Letter (Sample 2) to Physicians

(SCHOOL DISTRICT LETTERHEAD TO GO HERE)

Asthma may be affecting your patient’s school performance.

I permit my child’s doctor (named above) to communicate with school staff regarding my child’s asthma.

Parent’s Signature _________________________________________ Date______________ 
• Early Signs of an Asthma Episode

• Sample Asthma Action Plans

• Use of a Metered Dose Inhaler

• Use of a Peak Flow Meter

• How Asthma-Friendly Is Your School? Checklist

27

Asthma Education Materials
28 MANAGING ASTHMA: A GUIDE FOR SCHOOLS

Early Signs of an Asthma Episode

In asthma education programs, students are taught to identify early warning signs—

the physical changes that occur in the early stage of airway obstruction. These early 

warning signs usually happen before more serious symptoms occur. They alert 

students that it is time to measure their peak flow and take medication according 

to their action plan. Each student’s early warning signs should be documented in 

the student’s asthma action plan available in the school health room or clinic. Teachers 

should be aware of each student’s early signs and symptoms and enable students with 

asthma to take the proper steps to prevent more serious asthma trouble.

Recognizing the early warning signs of an asthma episode can avoid a more serious 

medical emergency. There should be no delay once a student has notified the 

teacher of a possible problem.

A student may have one or more of these symptoms during the initial phase 

of an asthma episode.

1.	 Changes in breathing

Early signs may include:

– Coughing

– Chest tightness

– Throat tightness

– Breathing through the mouth

Later signs may include:

– Wheezing

– Shortness of breath

 – Rapid breathing

2.	 Verbal Complaints

Often a student who is familiar with asthma will know that an episode 

is about to happen. The student might tell the teacher:

 – “My chest is tight.” 

– “My chest hurts.” 

– “I cannot catch my breath.” 

– “My mouth is dry.” 

– “My neck feels funny.” 

– “I don’t feel well” or “I feel tired.” 

– “My chin (or neck) itches.”—the student may rub his or her chin 

or neck in response to this feeling. 

Students may also use “clipped” speech—very short, choppy sentences.
Sample (1) Asthma Action Plan

ST U D E N T AST H M A

AC TI O N CA R D

Name: Grade: Age:

Homeroom Teacher: Room:

Parent/Guardian Name: Ph: (h):

Address: Ph:(w):

Parent/Guardian Name: Ph: (h):

Address: Ph:(w):

Emergency Phone Contact #1

Name Relationship Phone

Emergency Phone Contact #2

Name Relationship Phone

Physician Treating Student for Asthma: Ph:

Other Physician: Ph:

EMERGENCY PLAN

Emergency action is necessary when the student has symptoms such as, _________________________ , ___________________,

_________________________ , _____________________or has a peak flow reading of ________________________.

• Steps to take during an asthma episode:

1. Check peak flow.

2. Give medications as listed below. Student should respond to treatment in 15-20 minutes.

3. Contact parent/guardian if

4. Re-check peak flow.

5. Seek emergency medical care if the student has any of the following:

Coughs constantly

No improvement 15-20 minutes after initial treatment

with medication and a relative cannot be reached.

Peak flow of ______________________

Hard time breathing with:

• Chest and neck pulled in with breathing

• Stooped body posture

• Struggling or gasping

Trouble walking or talking

Stops playing and canít start activity again

Lips or fingernails are grey or blue

• Emergency Asthma Medications

Name Amount When to Use

1.

2.

3.

4.

}

See reverse for more instructions

ID Photo

�

�

�

�

�

�

�
Sample (1) Asthma Action Plan (Continued)

DAILY ASTHMA MANAGEMENT PLAN

• Identify the things which start an asthma episode (Check each that applies to the student.)

Exercise Strong odors or fumes Other

Respiratory infections Chalk dust / dust

Change in temperature Carpets in the room

Animals Pollens

Food _______________________ Molds

Comments

• Control of School Environment

(List any environmental control measures, pre-medications, and/or dietary restrictions that the student needs to prevent an asthma

episode.)

• Peak Flow Monitoring

Personal Best Peak Flow number:

Monitoring Times:

• Daily Medication Plan

Name Amount When to Use

1.

2.

3.

4.

COMMENTS / SPECIAL INSTRUCTIONS

FOR INHALED MEDICATIONS

 I have instructed _______________________________________ in the proper way to use his/her medications. It is my

professional opinion that ________________________________ should be allowed to carry and use that medication by

him/herself.

 It is my professional opinion that _________________ should not carry his/her inhaled medication by him/herself.

Physician Signature Date

Parent/Guardian Signature Date

AAFA • 1233 20th Street, N.W., Suite 402 , Washington, DC 20036 • www.aafa.org • 1-800-7-ASTHMA

02/00






















Sample (2) Asthma Action Plan

National Asthma Education and Prevention Program; National Heart, Lung, and Blood Institute; NIH Publication No. 97-4053
32 MANAGING ASTHMA: A GUIDE FOR SCHOOLS

Use of a Metered Dose Inhaler

A metered dose inhaler (MDI) is a device used to deliver asthma 

medication directly to the lungs. In order to ensure effective administration 

of the medicine, the following steps should be performed:

1. Remove cap and hold inhaler upright.

2. Shake inhaler.

3. Tilt head back slightly and breathe out.

4. Position inhaler in one of the following ways:

A. Open mouth and hold inhaler 1–2 inches away.

B. Use spacer (recommended for children for any 

inhaled asthma medication and for adults/children 

using inhaled steroids).

C. Put inhaler in mouth.

(B is optimal, but C is acceptable if you have trouble 

with either A or B.)

5. Press down on inhaler to release medication as you start to 

breathe in slowly.

6. Breathe in slowly (3–5 seconds).

7. Hold breath for 10 seconds to allow medicine to reach deeply 

into the lungs.

8. Repeat puffs as directed. Waiting 1 minute between puffs 

may permit the second puff to penetrate the lungs better.
33

Use of a Peak Flow Meter

A peak flow meter is a useful tool for objectively measuring the 

severity of asthma. The number obtained is called a peak expiratory 

flow rate (PEFR). The PEFR indicates the degree of obstruction or 

narrowing of the airways. The PEFR is the amount of air that can 

be forcefully exhaled. Each individual has a predicted rate based on 

height and age. However, many physicians prefer to use the person’s 

“personal best” value. This number represents the highest rate 

obtained when a person is feeling well.

This procedure can help determine when medicine or a change in 

treatment is necessary. In order to ensure accuracy of the results, 

the test must be performed using the correct technique. The 

following steps outline the procedure for this test.

1. Place indicator at the base of the numbered scale.

2. Stand up.

3. Take a deep breath.

4. Place the meter in the mouth and close lips around the 

mouthpiece.

5. Blow out as hard and fast as possible.

6. Write down the achieved value.

7. Repeat the process two more times.

8. Record the highest of the three numbers achieved.

This procedure can help determine when medicine or a change in 

treatment is necessary.
National Heart, Lung, and Blood Institute

National Asthma Education and Prevention Program

School Asthma Education Subcommittee

How Asthma-Friendly Is Your School?

Children with asthma need proper support at school to keep their asthma under control and be fully active. 

Use the questions below to find out how well your school assists children with asthma:

 Yes  No 1. Is your school free of tobacco smoke at all times, including during school-sponsored 

events?

 Yes  No 2. Does the school maintain good indoor air quality? Does it reduce or eliminate 

allergens and irritants that can make asthma worse? Check if any of the following 

are present:

  Cockroaches

  Dust mites (commonly found in humid climates in pillows, carpets, upholstery, 

and stuffed toys)

  Mold

  Pets with fur or feathers

  Strong odors or fumes from art and craft supplies, pesticides, paint, perfumes, 

air fresheners, and cleaning chemicals

 Yes  No 3. Is there a school nurse in your school all day, every day? If not, is a nurse regularly 

 available to help the school write plans and give the school guidance on medicines, 

physical education, and field trips for students with asthma?

 Yes  No 4. Can children take medicines at school as recommended by their doctor and parents? 

 May children carry their own asthma medicines? 

 Yes  No 5. Does your school have a written, individualized emergency plan for each child in case 

 of a severe asthma episode (attack)? Does the plan make clear what action to take? 

 Whom to call? When to call? 

 Yes  No 6. Does someone teach school staff about asthma, asthma management plans, and 

 asthma medicines? Does someone teach all students about asthma and how to help a 

 classmate who has it? 

 Yes  No 7. Do students have good options for fully and safely participating in physical education 

 class and recess? (For example, do students have access to their medicine before 

exercise? Can they choose modified or alternative activities when medically 

 necessary?)

If the answer to any question is “no,” students in your school may be facing obstacles to asthma control. 

Uncontrolled asthma can hinder a student’s attendance, participation, and progress in school. School staff, health 

professionals, and parents can work together to remove obstacles and promote students’ health and education.

Contact the organizations listed on the following pages for information about asthma and helpful ideas for 

making school policies and practices more asthma-friendly. Federal and State laws are in place to help children 

with asthma.

Asthma can be controlled; expect nothing less.
35

Resources Available to Schools 

To Help Manage Asthma

For more information contact:

The National Asthma Education 

and Prevention Program

NHLBI Health Information Center

P.O. Box 30105

Bethesda, MD 20824-0105

www.nhlbi.nih.gov 

(301) 592-8573 

TTY (240) 629-3255 

The following organizations can provide additional 

materials and additional information about asthma:

Allergy and Asthma Network/

Mothers of Asthmatics, Inc.

2751 Prosperity Avenue

Suite 150

Fairfax, VA 22031

www.aanma.org 

(800) 878-4403

American Academy of Allergy, 

Asthma, and Immunology (AAAAI)

Patient/Public Resource Center

611 East Wells Street

Milwaukee, WI 53202

www.aaaai.org 

(800) 822-2762

American Academy of Pediatrics 

141 Northwest Point Boulevard

Elk Grove, IL 60007

www.aap.org 

(847) 434-4000

American College of Allergy, Asthma, 

and Immunology

Resource Center

85 West Algonquin Road

Suite 550

Arlington Heights, IL 60005

allergy.mcg.edu 

(800) 842-7777 
36 MANAGING ASTHMA: A GUIDE FOR SCHOOLS

American Lung Association

National Office

1740 Broadway

New York, NY 10019

www.lungusa.org

(212) 315-8700

(or call your local Lung Association office)

Asthma and Allergy Foundation of America

National Headquarters

1233 20th Street, NW

Suite 402

Washington, DC 20036

www.aafa.org

(800) 727-8462

Centers for Disease Control and Prevention

4770 Buford Highway, NE MSK-12

Atlanta, GA 30341

www.cdc.gov/asthma 

www.cdc.gov/HealthyYouth/asthma

(800) 311-3435

National Association of School Nurses

P.O. Box 1300

Scarborough, ME 04070-1300

www.nasn.org

(877) 627-6476

(877) NASN4SN

U.S. Environmental Protection Agency (EPA) 

Information Clearinghouse 

Headquarters

1200 Pennsylvania Avenue, NW

Washington, DC 20460

www.epa.gov

(800) 438-4318


Discrimination Prohibited: Under provisions of applicable 

public laws enacted by Congress since 1964, no person 

in the United States shall, on the grounds of race, color, 

national origin, handicap, or age, be excluded from 

participation in, be denied the benefits of, or be subject 

to discrimination under any program or activity (or, on 

the basis of sex, with respect to any education program 

or activity) receiving Federal financial assistance. In 

addition, Executive Order 11141 prohibits discrimination 

on the basis of age by contractors and subcontractors 

in the performance of Federal contracts, and Executive 

Order 11246 states that no federally funded contractor 

may discriminate against any employee or applicant 

for employment because of race, color, religion, sex, or 

national origin. Therefore, the National Heart, Lung, and 

Blood Institute must be operated in compliance with these 

laws and Executive Orders.
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

National Institutes of Health

National Heart, Lung, and Blood Institute

NIH Publication No. 02-2650

Originally Printed 1991

Revised July 2003