The increasingly sensitive feelings of the school-age child and adolescent often cause him/her to turn against the sickness and to hide from the surroundings and the doctor. Sometimes the only sign of asthma is hyperinflation of the lungs, since the child has learned to breathe very shallowly to avoid wheezing. A peak flow meter is a good way to help the child objectively understand their condition.

 

Pollen, house dust mites and animal proteins are the most common allergens in this age group. Environmental control is again the first line of action and can reduce the amount of medication needed.

 

Exercise-induced asthma is a condition which is commonly overlooked in children. It is often a sign of a badly controlled chronic asthma. It can have an important impact on the physical and mental well-being of a child with asthma. The child may avoid exercise to prevent symptoms, but at the cost of exclusion from his peer group and at the risk of establishing sedentary habits that may increase health risks later in life. The child should be encouraged to choose sports which are less likely to induce asthma. Swimming is the most appropriate, followed by sports that emphasize coordination over exertion, such as gymnastics, tennis or golf. Sports requiring extended periods of running are not always appropriate.

 

Prophylactic asthma medications, given before exercise, will effectively prevent the onset of exercise-induced asthma. Inhaled drugs are taken immediately before exercise, orally administered drugs 1 or 2 hours before. A period of gradual warming up before exercise is recommended. In many children, however, certain exercise restrictions may need to be imposed, for example on cold days, during the pollen season, or when the child has an infection. Teenagers with asthma should be advised to take their allergies into consideration when planning their future studies, work, and social life.