Patient description: The patient is a 15-year-old boy with asthma diagnosed a year ago. He presents with shortness of breath, chest tightening and cough. According to his mother, he didn't respond to the usual corticosteroid inhaler. He was admitted to the emergency department with diagnosis of severe asthma exacerbation. He is a candidate for general corticosteroid therapy. Spirometry revealed a forced expiratory volume in the first second (FEV1) of 60% of the predicted. His past medical history is non-significant. His family history is significant for asthma in his mother and his uncle. He used to be treated with combination of inhaled corticosteroids and Zafirlukast.

Clinical trial eligibility criteria: eligible ages (years): 6.0-17.0,  Asthma Rhinitis Participants who meet all of the following are eligible for enrollment. Participants may be reassessed if not initially eligible. Participants are eligible if they Are male or female ages 6-17 years, inclusive, at recruitment Have a physician diagnosis of asthma Have had ≥ 2 episodes of short-acting beta-agonist administration within the past 12 months, exclusive of use associated with exercise-induced symptoms Have a primary place of residence located in one of the pre-selected recruitment census tracts as defined in the APIC Manual of Operations Meet pretreatment requirements for study enrollment (acceptable medical history and physical examination results) Have a parent or legal guardian who is willing to sign the written Informed Consent prior to initiation of any study procedure Are willing to sign the assent form, if age appropriate Have medical insurance at the Screening Visit. Coverage must be in effect from Screening through Enrollment in order to be enrolled  Participants who meet any of the following are not eligible for enrollment but may be reassessed. Participants are ineligible if they Have had ≥ 2 life-threatening asthma exacerbations in the last 2 years requiring intubation or mechanical ventilation, or resulting in a hypoxic seizure Are pregnant or lactating. (Females of child-bearing potential must remain abstinent or use a medically acceptable birth control method (e.g. oral, subcutaneous, mechanical, or surgical contraception) throughout the study. This is not for safety, but because it may be difficult to assess asthma control since lung function may change, making it difficult to interpret outcome measures) Will not allow the study clinician to manage their disease for the duration of the study or who are not willing to change their asthma medications to follow the protocol Are unable to use a metered-dose inhaler (MDI) for administration of a beta-agonist rescue medication or use a dry powder inhaler (Diskus®) for the administration of asthma controller regimens Are currently receiving hyposensitization therapy or have received hyposensitization therapy to any allergen in the past year prior to recruitment Are currently participating in an asthma-related pharmaceutical study or intervention study or who have participated in another asthma-related pharmaceutical study or intervention study in the month prior to recruitment Do not sleep at least 4 nights per week in the same home Have a sibling or other person living in the same home enrolled in the study Live with a foster parent; not applicable if participant is able to provide consent