Almost 5 million U.S. children have asthma, according to a 1998 report in the American Journal of Respiratory and Critical Care Medicine. The National Asthma Education and Prevention Program (NAEPP, a project of the National Institutes of Health) recommends that children be directly involved in asthma management as soon as they’re ready. But when exactly is that?

Children learn skills at different ages and rates, but the sequence of learning steps is the same. When you first introduce your child to a task, you do the work while the child looks on. After the child becomes comfortable with the task, the two of you work together. Finally, the child tries the task alone while you look on. Older children follow this same path of learning, although they may move through it more quickly. Understanding this progression can help you decide whether your child is ready to take on a new responsibility. You also need to think about the following: ability, reliability, and responsibility.

Ability

First, consider the child’s ability — his or her physical readiness for the task. A child who can blow bubbles or blow out candles may be ready to try blowing into a peak flow meter. A child who pours fluids without too much spilling or who has enough dexterity to play computer games may be ready to handle a face mask, metered dose inhaler, or peak flow meter under your supervision. Some behaviorists say it takes 49 repetitions to make any particular task a habit, so don’t rush. Make much of successes, and encourage your child through progress even when he or she makes mistakes.

Reliability

Next it’s time to work on reliability. Before a child can reliably complete a series of tasks (like cleaning an entire room), he or she must first be able to complete a single task independently. Can your child take on a single task, such as making a bed, and report back to you? If so, he or she may be ready to take on a single self-care responsibility with only a verbal reminder. The child who is not quite ready for independent self-care can still put away the peak flow meter, or record medication taken in their asthma management diary (with a rubber stamp if need be).

Start your child on the road to reliability with a single, simple self-care task (like putting away the peak flow meter after using it) and a reward. A sticker chart offers instant reward for younger kids. Older children are better motivated by a cumulative reward for repeat successes. For example, give the child a token for each success, then trade a set number of tokens for a larger reward (like a trip to the park).

Responsibility

Now that your child has shown ability and reliability with a single self-care task, it may be time to give him or her more responsibility. If you trust your older child to respect boundaries, you may also trust him or her with a more important self-care task. The child who respects a statement like “that part of the playground is off limits” is beginning to understand that actions have long-term consequences. This understanding is crucial, because asthma self-care responsibilities (like taking long-term control medications) often don’t offer the instant results that motivate younger children.

Once your child takes on a more important task, like morning medication for example, you still must keep an eye on his or her reliability. But be discreet. Helping your child gain the confidence to manage asthma takes a delicate balance of unobtrusive supervision and increasing trust.

As your child starts handling responsibilities, show your trust by encouraging him or her to talk directly with the doctor during checkups. As your child grows more comfortable with self-management, your role will become that of observer, cheerleader, and supporter.

This entry was posted on Friday, December 21st, 2007 at 10:56 am 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.