Asthma Treatment Guidance via the Pediatric Asthma Yardstick

Having an effective and appropriate plan of care is essential when treating asthma and striving for asthma control. But when it comes to kids, this can get tricky. Around 10% of school-aged children have asthma. Unfortunately, the diagnosis and treatment of asthma in children is quite different from adults. There are also differences in asthma management in the 3 age groups of children:

  • Infants and kids up through age 5
  • School-age children (ages 6-11)
  • Adolescents (ages 12-18)

Each age group will experience asthma somewhat differently as their respiratory systems develop and change. Emotional and social concerns can also play a part, especially in teens.

The Challenges of Asthma in Kids

There are a number of challenges when it comes to managing asthma in children. First of all, diagnosis can be difficult, as doctors must rely largely on symptom observance, rather than objective testing. Plus symptoms like wheezing and coughing are often related to viral infections, rthe ather than asthma, which can confuse diagnosis. Finally, research into safety and effectiveness of asthma medications in children is limited.

There are also a variety of options for treating asthma in children. But some experts believe that specific guidance on how to apply these options throughout childhood have been lacking.

Thus, the Pediatric Asthma Yardstick

To combat these challenges, the American College of Allergy, Asthma and Immunology (ACAAI for short) created the Pediatric Asthma Yardstick. It was published in the Annals of Allergy, Asthma and Immunology, the scientific journal of ACAAI, in June 2018.

This tool is a user-friendly care guide for physicians. The Yardstick is meant to help health care professionals understand which controller treatments are right for which age groups and how to identify when a step up in treatment is needed to achieve asthma control.

According to allergist Bradley Chipps, MD, ACAAI President and lead author of the paper, the Pediatric Yardstick is “… a roadmap for how to move forward with kids whose asthma is not under control. The yardstick describes controller treatments at different levels of severity for all ages, the choices available for parents for their child and how to step up therapy.”

The Yardstick is designed as a practical resource for clinicians. It helps identify children with problems with asthma control who need a step-up in treatment. Recommendations for starting or adjusting controller medications are organized around specific age- and severity-related patient profiles. They are also based on current best practice guidelines and the authors’ clinical experience.

Achieving asthma control in kids can be elusive. It is hoped that this more detailed treatment guideline will enhance asthma control throughout our population. If it does, that will improve quality of life for kids and their families. It will also translate to less missed school days and fewer ER visits and hospitalizations.

In Summary

Keep in mind that the Pediatric Asthma Yardstick is a tool, not an absolute plan for guaranteed success. Every child is different, as is their asthma course of illness. Health care professionals and parents still need to work closely together to identify the challenges, develop goals for treatment and measure success.

How to define good asthma control in a specific child and how to achieve it require regular discussion and agreement among the child patient, family, and doctor.

With the Yardstick, these actions will hopefully go more smoothly. If you’re a parent of a child with asthma, make a point to talk with your doctor about this care guideline. Your child’s future health may depend upon your advocacy!

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