Most schools are likely to have several students with asthma, which means that many teachers — plus school nurses — will be very familiar with helping children with asthma. However, you still have a role to play in making sure that your child gets appropriate attention for his condition and that all the relevant school staffers are familiar with what is needed to help your child during the school day.

Teachers and Asthma

In a classroom of about twenty-five students, teachers can expect to have at least two to three children with asthma. While you should check to see if your child's teacher has his action and daily action plans on hand, you also should ask if that teacher has had additional training from the school to spot asthma symptoms and to immediately address any emergencies that could arise.

In-service or professional development courses can be taught by a school nurse, a local hospital, or community organizations that focus on children with asthma. These courses can discuss when to refer a child to a nurse because of symptoms (such as wheezing, a pale and sweaty face, repeated coughing, or low peak flow readings), or side effects that are interfering with breathing or performing school activities.

Training also can assist teachers in learning about how to stop an asthma attack by encouraging relaxation or deep breathing (possibly by modeling the technique), providing warm water to drink, and, if needed, using quick-relief or rescue medication.

The message should be emphasized to your child that he must speak up — and not be embarrassed — to tell his teacher if he is experiencing any difficulties, such as labored breathing or wheezing, so the teacher can act promptly.

Additional training also can help teachers address the child's feelings, for instance, of being somewhat different than her classmates, anxiety over the use of medications, or embarrassment of having an asthma attack.

You should receive acknowledgement from your child's classroom teacher or teachers that they have received his asthma action plan. If possible (particularly for the elementary grades), review it with the teacher to see if any modifications are needed in the classroom such as removals or repairs to avoid various asthma triggers.

Also, ask the teacher to set up a procedure addressing how missed schoolwork should be handled if your child has an asthmatic episode or is absent from school.

And above all, support the teacher's efforts to get your child to participate in all classroom activities. While there may be circumstances that may aggravate asthma symptoms on school days — such as changes in weather (hot, cold, or breezy) or poor air quality — your child likely will want to feel like “one of the guys.”

School Nurse as Advocate

Schools with a full-time nurse can provide a valuable service to your child by monitoring her condition, overseeing the use of medication, or working with your family to suggest effective management strategies at home. However, many schools, because of budget cutbacks, do not have the resources for providing the services of a full-time school nurse.

The school nurse or other designated staff member can help review or develop your child's individual asthma action plan with your family and distribute it to your child's teachers. The nurse should also communicate with you throughout the school year to report attacks or update information found in the plan.

The National Association of School Nurses (www.nasn.org) has created a form that can be sent home to parents that can indicate whether your child's action plan is working. The forms flag signs that a child's asthma is not under control or where medication is not being used or is being used inappropriately.

And, the nurse is a “teacher” in that she can answer your questions about asthma, provide information and in-service courses to staff members about asthma's impact on students, and assist students and helping them with their self-management skills.

Principals and Head Administrators

Principals and head administrators have clearly defined roles as well. They should help initiate and implement an asthma management program throughout the school, and select the individual (usually the nurse) who is in charge — along with a backup designee if the nurse is not available.

Working with you, the school nurse, and medical professionals, principals or administrators can also help develop the policies that ensure medication administration is safe, reliable, and effective, and — when appropriate under current school system policies — permit self-administered medication. They also can clarify policies about taking medications during field trips, after-school programs, and other school-related events outside the regular school day.

Principals or administrators also can provide appropriate guidance for outside play — to protect students from extreme temperatures, high pollen counts, and air pollution that can affect children with asthma.

Other Staff Roles

Building maintenance staff can play important roles in the life of an asthmatic child by identifying indoor air quality problems including mold growth, improperly maintained ventilation systems, and possible chemical pollutants from chemistry or art classes.

They also can play important roles in minimizing allergen and irritant levels through regular cleaning and maintenance schedules. And, they can stop problems before they start by scheduling renovation or major repair work when students are not in the school building.

Guidance counselors, social workers, or school psychologists can smooth the path out for your child at school by making sure he is treated the same as all other children, except when addressing his asthma needs.

They also can help your child deal with the stress of a chronic condition — helping them address anxieties or pressures they might feel from time to time. And they can assist students in resolving issues related to school policies or practices, along with his asthma management.

They also can help school staff better understand what asthma is — an inflammation of the lungs and not something going on in a child's head or an excuse not to do something.

Gym, Sports Teams, and Outdoor Play

The individuals that teach or coach your child in sports or other physical activities need to have access to your child's asthma action plan. In particular, they should have an understanding of your child's premedication procedures, and then know — and have readily available — the child's quick-relief medications.

They also make sure that an asthmatic child's medications are available for any sports or athletic activities occurring away from school or outside of school hours.

A good instructor will encourage your child to participate in sports, but also respect her limits when she says she is unable to participate in an activity. Sometimes the instructor needs to recognize the need to adjust for the pace or intensity of activities — or substitute some activities — due to weather or air quality issues.