If you believe your child has the symptoms of asthma, especially recurrent episodes of coughing or wheezing, call your health care provider. He or she may schedule a diagnostic exam to learn whether asthma might be the cause. What can you and your child expect from a diagnostic exam? That depends in part on the child’s age.

The National Asthma Education and Prevention Program (NAEPP, a project of the National Institutes of Health) notes that infants and children younger than 5 years old can be misdiagnosed as having bronchiolitis, bronchitis, or pneumonia. Since asthma treatment can’t begin until after an asthma diagnosis, the NAEPP reports that many of these children do not receive adequate treatment.

A diagnostic asthma exam for children under 5 years old will include a detailed medical history and a physical exam (focusing on the upper respiratory tract, chest, and skin). A spirometry test (which measures airway function) is seldom possible for young children, so other tests may be ordered. These might include a chest x-ray, allergy tests, nasal exam, or other clinical tests.

For children over 5 years old, a diagnostic exam is not much different than that for adults. Along with the detailed medical history and physical exam, older children may be able to have a spirometry test to measure airway function. Your child’s health care provider may also schedule other tests, such as a chest x-ray, allergy tests, or a nasal exam.

You may be asked to monitor your older child’s peak flow for a week or more. Peak flow is the maximum amount of air your child can exhale. The child breathes into a peak flow meter and you note the results in a peak flow diary. Your child’s doctor will show you how it’s done and explain how often to do it.

Medical history

According to the NAEPP, a complete history of your child’s asthma symptoms is essential to a pediatric diagnostic exam - and only you can provide it. Your child’s doctor is counting on you to give the details needed. Every time you notice symptoms, record them (and possible exposure to asthma triggers) on paper. According to the NAEPP, the following clues may point to pediatric asthma:

• Recurring episodes of coughing, wheezing, chest tightness, or shortness of breath
• Symptoms that worsen after exposure to allergic triggers or exercise
• Ongoing nighttime symptoms
• The presence of other allergic disease (hay fever or skin allergies)
• Close relatives with a history of allergic disease

Spirometry test

A spirometry test measures the maximum volume of air your child can exhale. Help your child feel relaxed and comfortable for the test by “practicing” at home. Blowing soap bubbles (or party favors) requires similar breathing technique, and it’s fun. Once in the physician’s office, ask your child to show the doctor how well he or she can blow out. Even though blowing into a tube isn’t as fun as blowing bubbles, your child will understand what he or she is supposed to do. Offer a low-key reward for effort, perhaps a new bottle of bubble soap or a special sticker.

After the first measurement, your child may then repeat the measurement after inhaling a bronchodilator (a medication that opens airways when asthma is present). The difference between the two readings is a measurement of the body’s reaction to the medication.

What if my child is diagnosed with asthma?

Now that your child is diagnosed, he or she can be treated for asthma and lead a normal life without symptoms. Talk to your health care provider about your concerns, learn all you can, and seek out other parents who have been there. You and your child will have some learning to do at first. Once you understand how asthma works and how it’s treated, you’ll probably find yourself worrying about asthma less.

This entry was posted on Monday, January 29th, 2007 at 4:56 pm and is filed under Kids. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.