Don't Miss It: Recognizing Asthma in Kids and Adults with Communication Challenges

A few years ago, the mom of a young woman I had provided respite care for off and on texted me with some questions about asthma. Her daughter was having what their doctor believed to be asthma symptoms, but with the daughter’s intellectual disability, it was difficult for her to communicate the symptoms she was experiencing. She asked some basic questions and of course, I was happy to provide her information to hopefully make their quest to correctly diagnose her breathing issues and treat her symptoms successfully a bit easier!

Over my years coaching young athletes with developmental disabilities, and working in childcare or doing respite, I have met many children who have both asthma and autism or another developmental disability. I never thought anything of it— of course, kids with other disabilities, whatever those may be, will likely experience asthma rates comparatively with the rest of the population, right?

Actually, it turns out that these kiddos may be at greater risk of developing asthma according to some research - and of course, it may be harder to tell what's going on. Understanding what's happening in younger children, as well as older kids and adults of all ages with communication difficulties can be a big challenge, since we cannot just see how someone's lungs are working!¹

Keeping your eyes open: Asthma warning signs

Asthma warning signs are pretty classic across the board, however, they can be sneaky, especially for people with communication challenges, from younger children through to older adults who may be experiencing cognitive decline.

Some things I have noticed and heard from others are the classic asthma signs like coughing, wheezing (which is actually less common as a symptom than coughing!), shortness of breath or sounding/feeling like they can't catch their breath, and chest tightness.

Sometimes, the muscles around the stomach or neck become involved, or breathing becomes more rapid, both of which can be signs that things are taking a bad turn for some, but in younger kids it can be a way to visualize how much work they are doing to breathe and to follow an asthma action plan (if they have an asthma diagnosis and a plan) or to seek medical care.

Allergy symptoms in conjunction may also be a clue. For example, watery or red eyes, sneezing, scratching, and again, some families of younger kids with asthma have noticed the child scratching their neck or chin and correlated this to asthma symptoms!

Communication challenges: Finding the words to describe asthma

A person may not recognize their symptoms as asthma but otherwise communicate their needs well. I have had the experience that a person may be short of breath and ask for water--this especially is true with exercise-induced asthma. I have observed this in a couple children thinking they were just tired from running around. I have also seen my grandma do this on a couple of occasions as well, reach for water when what she really needed was a rescue inhaler!

My grandma has Alzheimer's disease, and just today, she referred to what I would believe to be asthma symptoms being caused by a potential respiratory virus as being "choked up." I have heard her say this during another virus. She was simultaneously wheezing in both cases. I would not be surprised if children might also say their asthma may make them feel like they are choking, too, lacking other words to explain chest tightness with, or without, coughing!

I have not tried it, but I wonder if with younger kids, or adults with communication, developmental, or cognitive challenges, if picture cards indicating the chest/breathing and something heavy pushing down on it or being pulled around it might help them communicate their symptoms to a caregiver or parent, or if they would be too abstract. If you have tried something like this, I'd love to know how it went!

Don't miss it

Asthma is complicated on its own and can be hard to manage, but if you add in other communication challenges, including those experienced by people with developmental delays, dementia, or other disabilities, it may be even more challenging. As well, adults and children who experience these differences may also be have a hard time with pulmonary function tests, adding to the mystery, so medication trial-and-error may be all you have. With time and observation, it may be easier to pick up hints about how your loved one with communication challenges is breathing.

Do you have strategies to share about helping a person with communication challenges manage their asthma? We'd love to read them below!