Asthma, Part 3 — Restrictions and implications for school
Possible medication side effects
Side effects of asthma medications differ with the type of medication that is used.
If side effects of medication pose a significant problem, one should talk to the
doctor about possible solutions. It is important that medication not be stopped,
due to side effects, without first talking to the doctor. Some of the possible side
effects of medication for asthma include:
- tremor, rapid heart rate, insomnia, anxiety with short acting bronchiodialators
such as Albuterol, Proventil, Ventolin, Alupent, Maxair or Xopenex
- dry mouth with a class of medicines called "anticholingerics", such as Atrovent
- hoarseness or yeast infection in the mouth with inhaled steroids such as Flovent,
Pulmicort, Beclovent, Vanceril, Azmacort, Aerobid, Advair
- very slow growth, thinning of bones or osteoporosis with inhaled steroids at high
doses prescribed over very long time
- growth suppression and osteoporosis with oral steroids such as Prenisone, Prednisilone,
Prelone, Pediapred)
- rare headache, upset stomach with Leukotriene modifiers such as Accolate, Singlulair
- rapid heart rate, tremor, insomnia, and anxiety with long acting bronchodialators
such as Serevent, Foradil, Volmax
Physical/dietary/other restrictions
With proper treatment and control of triggers, most students with asthma can participate
fully in activities at school. In rare circumstances or when a child is having difficulty
with control of her asthma, an adaptive physical education program may be required.
The child’s doctor can determine if this is necessary.
When the child is not having
difficulty with her asthma, however, it is very important that she participate fully
in physical education, recess and any other activities. If the child is forced to
“sit on the sidelines”, it can cause her to feel isolated and different from her
peers.
If a child has food allergies that could trigger an asthma attack, it would be important
to ensure that the child did not consume those foods at school. Conferencing between
parents, school staff and health care providers can help determine what, if any,
food allergies may be of concern to the child with asthma.
Adequate fluid intake,
especially during symptoms of asthma, is recommended.
Implications for school
Several areas of concern may exist for the student with asthma at school, including
academic, social, and health concerns. It is recommended that the student be evaluated
for possible eligibility under IDEA as a student who is “other health impaired”
or for a 504 Plan.
Frequent absences may result in academic gaps for the student
with asthma. Missing vital academic information on a repeated basis may cause gaps
in the building blocks of learning. Thus, it is important to frequently monitor
the child’s progress, and ensure that essential components of learning have not
been missed. An IEP or 504 Plan will aid in developing a plan that will prevent
academic gaps for the student with asthma.
Social concerns may develop if a student restricted from physical activity or unable
to participate fully with her peers. If physical restrictions are recommended by
the child’s physician, other ways of including the child in school activities should
be emphasized. For example, if the child with asthma cannot participate fully in
PE, recess, or other physical activities, she should be given another meaningful
task to perform, such as score keeper, equipment manager, etc. Staying inside during
recess to read a book or complete homework missed due to an absence will suggest
that the child is different, and may lead to feelings of isolation or rejection.
Perhaps the child can invite classmates to engage in a game in the library during
recess, or in other ways stay connected with peers. Defined strategies to keep the
child involved and perceived as a regular class member are imperative for optimal
social adjustment.
Each child with asthma will have unique medical or health needs, and those should
be identified in a Special Health Care Plan, kept in the nurse’s office. This plan
can designate such things as potential triggers to asthma attacks, what to do in
case of an emergency, medication regimens, when to call 911 and much more. The school
nurse, parents, and health care providers should collaborate to develop a Health
Care Plan that addresses the individual needs of the student with asthma. In this
way, emergency situations may be avoided or responded to in the appropriate manner.
Asthma, Part 3 — Restrictions and implications for school
For more information, please contact:
Kathy Davis, MSEd, PhD
kdavis2@kumc.edu
(913) 588-6305