| Asthma and the School |
The main components in the care of childhood asthma are
These basic needs are the same whether the child is at home or at school, but the school setting offers some particular challenges to successful asthma management. Here are some suggestions for keeping your child's asthma care as strong and consistent at school as it is at home. By the way, please don't forget day-care and after-school programs! They need to be prepared to deal with your child's asthma, too! Communication - Communication is the primary ingredient in making sure your child's asthma is well managed at school. There is no substitute for face-to-face contact for establishing open lines of communication. Schedule a meeting with your child's teacher and with the school administration to talk about your child's asthma treatment (including triggers to be avoided). If your child's school is fortunate enough to have a school nurse, be sure to include him or her in your discussions! Many school nurses have special training in asthma and other conditions common in children. Continue to keep in touch with school personnel through the school year, to make sure any problems are addressed as they come up. Providing school personnel a written care plan is also essential. This care plan should be drawn up and signed by your child's physician. (Sample care-plans are available on-line. If your doctor's office does not have its own standard form, print out one of the samples and take it for the doctor to fill in.) Make sure you also include telephone numbers to call in case of emergency. Once you have a completed care plan, make several copies. Give one to the school office to keep on file. Give one to your child's teacher (and go over it with him or her to ensure understanding). Finally, have your child keep one (in a pocket or a backpack, for example) to have on hand in case it is needed. Keep the written care plans up-to-date. If there are changes in medications, or if new triggers are uncovered, don't forget to alert the teacher and the school administration in writing. Well-controlled asthma should not prevent a child from participating in most school activities, including gym class. There may be times, however, when a child experiences a flare-up in asthma symptoms and cannot tolerate exercise. Consult with your child's doctor and provide the school specific written instructions about your child's physical activity. Include any pre-activity treatment recommended as well as guidelines for when the child should have his/her participation in exercise modified or restricted. Legal Protection - Much of the time, teachers and school administrators are very responsive to the needs of students with asthma, but there can be difficulties and frustrations. You should know that federal law prohibits discrimination in education against students with chronic health conditions such as asthma. If a school has policies or practices that interfere with a student's access to education because of a chronic health condition, you can take action under Section 504 of the Rehabilitation Act of 1973. More information about Section 504 protection is available from the Council of Educators for Students with Disabilities. You can also contact the Office for Civil Rights in your region for help in understanding and applying Section 504. Inhalers in the Classroom? - A question that generates a lot of controversy across the country is whether children should be permitted to carry their asthma medicines with them during the school day. Some people believe that children cannot be relied on to take their own medicines correctly. They recommend that medicines such as inhalers be kept in the school nurse's office (or in the school administrative office, if there is not a school nurse) where access to them is controlled. Many asthma organizations, however, have come out in favor of allowing children to carry their asthma medicine (at least their rescue inhaler) with them. They point out that for best effectiveness, rescue medicines should be taken very soon after symptoms begin. Leaving class and going to the office is disruptive to the child and to the class. It takes extra time, is inconvenient, and the child may put it off even as asthma symptoms are worsening. Most children are able to understand basic concepts relating to their asthma, and to follow simple guidelines in using their medications. Keeping the teacher well informed of the action plan is important so he/she can help guide the child in using the inhaler correctly. In addition to providing inhalers to be used at school, parents should also consider providing a peak-flow monitor for assessment of lung function in case of asthma symptoms. In order for a child to have medicines in school, most schools require a form filled out jointly by the parents and the child's doctor. This is often referred to as a "504 Form". The school secretary should have blank forms available. It is a somewhat lengthy and unwieldy form, but having it completed can prevent a lot of problems down the line. Whether the inhaler is in a school office or with the child, it is important to remember that children are often sensitive to feeling conspicuous and different. They may avoid going to the office or using their inhaler in front of other children. Gently asking a child about these feelings can allow a parent to help the child plan a way to take needed medicines with the least discomfort possible. (Ironically, as asthma gets ever more common across the country, this embarrassment aspect, at least, may be less of a problem. Having asthma is no longer so unusual, and chances are increasing that multiple children in any given classroom will have the disorder.) The School Environment - An important factor in an asthmatic child's school experience is the physical environment of the school itself. Just as in the home, the child's exposure to asthma triggers should be reduced to the extent possible. When meeting with school officials about your child's asthma care plan, ask specifically about your child's possible exposure to his or her triggers. For instance, is a furry or feathered animal kept in the classroom? Are strong-smelling products used for cleaning while students are present? Is there dust or mold in the classroom or in the school ventilation system? Is there a cockroach problem in the school? If a teacher or school administrator is unable to rectify these problems, taking the matter to the parent's association or the school board may get results. The Environmental Protection Agency has specific, step-by-step instructions for making schools healthier for asthmatic children. Asthma Education for the Schools - As asthma becomes more common, educating everyone about it is increasingly important. There are several asthma education programs specifically designed for schools in which all students (not just the ones with asthma) learn about healthy breathing and about asthma. If your child's elementary school does not already have an asthma awareness program, contact the American Lung Association about their Open Airways for Schools program, and how you can help get one started in your area. For older children and teenagers, there is the Power Breathers group. |
