Coping Strategies for School
Children and Teens
Ten year old Lisa writes: "One
day in gym class I was playing soccer and running hard. All of a
sudden it got harder and harder to breathe. I knew I had to sit
down to rest, so I did. But the teacher made me go back into the
game. She was not my regular teacher so she didn't know I had asthma.
I guess she thought I was just 'being lazy'. I barely managed to
run for a few more minutes until the bell rang. Then I went to take
my Ventolin and talk to my regular teacher. My teacher felt bad
that this happened and went to talk to the other teacher about it.
In the end she came to apologize. By then I felt better, so it was
okay. But at the time I felt like crying when the teacher made me
go back into the game, when I knew, I needed to rest. Sometimes
it's hard to keep up with the others in your class if you have asthma."
The goal of asthma management is to
allow your child to lead as normal a life as possible. This means
that he/she should be able to participate in sports. However, each
asthmatic child has a different level of tolerance to exercise.
As well, there will be good days and bad days. On good days, there
may be no problem, on bad days the tolerance level may be very low.
How do we know when it's going to be a bad day? Outdoor exercise
on a windy, dusty spring or fall day will often bring on an asthma
attack; as well as outdoor exercise in temperatures of -20º
C or colder. We know that high pollen count days in spring and grain
dust in the air at harvest time causes problems, as does cold winter
air. There are also times when the tolerance level is low because
of a viral infection. Each child has his/her own "sensitive"
times and it is very important to pay attention to these.
It can be very frustrating for a child
with poorly controlled asthma (and/or allergies) to try to keep
up with the rest of the class. Each child should be allowed to participate
in physical activities until they reach their own "limit".
Generally a child with asthma knows when they reach this level.
How children cope with asthma is often
related to the attitude of the people around them regarding their
condition. By keeping lines of communication open and allowing children
to express their feelings about it, a healthy outlook about asthma
is more likely to occur.
To determine how your child is coping
with asthma you could ask him or her the following questions and
then analyze the answers to help create an action plan for them
1. "What is the hardest part about
having asthma, especially at school?"
(A typical answer might be: wheezing during gym
having a coughing
having to use an inhaler
2. "How can things be made easier
for you at school?" (A typical answer might be: It would be
better if there were no pets
or if the teacher would believe
me when I can't run, play basketball, etc. and that I'm not trying
to "wimp out
" or if the class would understand my
asthma the way they do "Sally's" diabetes).
An allergic/asthmatic child's performance
cannot be expected to be consistent. Achievement will be high on
the days the child is feeling well. There will also be days when
allergy and asthma-related problems surface. These are the days
when your child's performance will not be up to your hopes, the
teacher's standards and most important, your child's expectations
of themselves. On these days the child needs a hug, not a scolding,
plus some consolation for the positive efforts they make will ensure
better days ahead. An informed and understanding teacher can do
a lot to improve the overall well-being of an asthmatic child. In
elementary school, write a letter to the teacher explaining your
child's specific situation. This letter should include information
explaining what can happen, what to do if it does happen, and what
situations can cause the problems for your child (see sample below).
The letter to the teacher(s) should
be available at the beginning of each school year. Also it is important
to follow up with the teacher to see if there are any concerns regarding
the information provided. Most teachers have had some experience
with an asthmatic child since approximately 20% of children have
some level of asthma. However, it is important for teachers to remember
that they cannot compare one asthmatic child to another, as the
degree of severity can be considerably different. It is also important
to check the information in the letter has been made available to
the gym teacher.
14 Year Old Laura's
Tips & Tricks for Dealing with Asthma
§ use your inhaler before playing sports if you find
exercise is affecting your asthma
§ take daily medication faithfully (taking preventative
§ don't smoke or hang around people who do
§ keep your room relatively dust-free (it may be painful,
but it helps)
§ try not to get too tired or run-down as this makes
you more vulnerable to viruses (e.g., common cold) which can
stay with you longer if you have asthma
Be aware when:
1. playing soccer in the spring or outdoor Phys. Ed. Classes
2. running (i.e., during basketball) or being in a dusty gym)
3. being around strong smells, i.e., paint, tar, cleaning
products (school renovations)
4. going to a friend's house where there are pets (talk to
you doctor about premedicating in this situation)
Many people don't believe that asthma
can be a problem for your child. However, in reality, children may
go through difficult experiences whenever they are around others
who are not educated about asthma. What can we do to help avoid
these psychological side effects?
1. Educate those around you about asthma and its effects. Talk to
your family, write letters to teachers; speak to school groups,
friends, neighbours, babysitters, etc. Help them to understand what
asthma means for your child.
2. Listen to and believe the child. They are not going to "fake"
an asthma attack because it really isn't "fun" to struggle
for each breath.
3. Take your child to the doctor for regular check-ups. Asthma medication
should be assessed regularly to help keep asthma under control.
This will also prevent asthma attacks, which in turn will help your
child's emotional status by allowing participation in most day-to-day
4. Become involved with the Allergy/Asthma Information Association
or your local Asthma Support Group. This will help you as a parent
to learn more about asthma, as well as enable you to talk to others
who are dealing with the same or similar situation.
5. But most of all, have fun with your child so that he/she develops
a positive attitude so important for coping with asthma on a daily
Unique circumstances for teens with
asthma include less parental involvement in schooling, i.e., field
trips, track & field days, and/or busing. There is also the
issue of more exposure to allergens including the addition of vending
machines, concessions, or a cafeteria in junior high and high school
(e.g., peanut allergy issues). Sometimes exposure to friends who
smoke, or use of scented personal care products such as hairspray,
cologne, aftershave, etc., will trigger an asthmatic's sensitivity.
Teens are notorious for having altered sleep patterns such that
they want to stay up late at night and prefer to sleep late during
the day. However, early classes at school often prevent them from
getting adequate sleep. This in turn causes them to get "run-down",
encouraging viral infections. Rescue inhalers need to be available
at all times - especially when playing sports or participating in
classes where asthma triggers are prevalent (e.g., industrial arts).
Teens are learning to test their independence and are developing
their own sense of worth and self-esteem. They tend to put more
importance on what their friends think than what their parents say.
It is important to allow your child to start making their own decisions,
but with some subtle guidance from you.
In conclusion, coping skills from asthma
vary from one child to another, and from one teen to another. But
no matter what age your son or daughter is, you can continue to
advocate for your child. In the younger school years writing a letter
(see below) to the teacher/s is helpful; even in the junior high
school years. By senior high school, there is generally less parental
involvement in schooling. By then, the teen can usually speak up
for themselves, however in certain situations, the parent may still
need to assist on the teen's behalf (e.g., Phys. Ed. Teacher doesn't
acknowledge limitations due to asthma). As a parent, it is important
to assess each situation on an individual basis. Encourage your
child/teen to participate in sport; get enough rest; and limit social
activity when necessary. Above all, whether child or teen, see your
doctor for regular checkups to determine whether the medication
being used is controlling the asthma to its best potential.
SAMPLE LETTER for the Teacher
Your address and phone number
RE: Lisa Smith
Lisa Smith is a moderately severe asthmatic. Her asthma is controlled
by a daily medication routine at home. There are times, however,
where she may require medication at school. Certain physical activities
seem to cause problems. Endurance exercise such as running and skipping;
sports such as soccer, floor-hockey, volleyball and basketball may
cause an asthma attack. She should be allowed to participate until
she reaches her own well-known limit. At this point, she must be
allowed to rest. There may also be times when she will need to spend
recess indoors, especially during cold, windy or wet weather, or
when her asthma has flared up.
An asthma attack is characterized by
increased coughing, wheezing, shortness of breath, struggling to
breathe, and in extreme cases, cyanosis or bluish lips. If Lisa
appears to be having an asthma attack at school:
1. have her sit down to rest, not lie down.
2. speak to her calmly, don't panic
3. encourage her to use her medication (Ventolin) which she carries
in her backpack
4. call me at the provided phone number.
If you are unable to reach me and the breathing difficulty continues
after using the Ventolin, please call an ambulance to take her to
____________ Hospital Emergency Department. Her doctor is ___________
and her Health Care number is ___________.
Lisa's asthma attacks have been triggered
by exposure to animals (e.g., cats, dogs, etc.), dust, pollens,
smoke, exercise, cold air, and viral infections. Strong odours such
as perfumes, paints and chemical cleaners may also cause problems.
Please help us monitor Lisa's asthma
by contacting me if she needs to stop physical activity, miss recess
outdoors, or seems to be overusing her medication due to asthma
symptoms. If you have any questions or other concerns about her
asthma, please feel free to call me at the provided phone number.
Yours sincerely, Mrs. Smith
Box 100, Toronto, Ontario M9W 5K9
Phone (416) 679-9521 or 1-800-611-7011 Fax: (416) 679-9524
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This article courtesy of the Allergy/Asthma
Information Association at www.aaia.ca and the Calgary Allergy Network
web site at www.calgaryallergy.ca. May be reproduced for educational,
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