Kids with asthma may struggle in school

Kids with asthma may struggle more in school when their symptoms are not well-controlled, and minority students with this breathing disorder are more likely to fall behind than their white counterparts, a US study suggests.

Asthma is one of the most common chronic diseases in childhood. Severe asthma attacks and breathing problems are associated with an increased risk of health problems like obesity as well as academic challenges like chronic absences from school and cognitive impairments that can lead to lower grades and test scores; city kids with asthma are particularly vulnerable to flare-ups because they often live with worse indoor and outdoor air quality and have fewer safe places to play and exercise outdoors, previous research has found. 

For the current study, researchers looked at asthma and allergies, lung function, school attendance, and academic performance for 182 Latino school children, 182 black students and 81 white kids. All of the kids were between seven and nine years old and students in one of four large urban public school districts. 

“We found associations between poor asthma status, poorer asthma control, lower lung function, more asthma symptoms, and decline in academic performance,” said lead study author Daphne Koinis-Mitchell of Bradley/Hasbro Children’s Research Centre in Providence, Rhode Island. 

“These associations were stronger in ethnic minority children, particularly Latino children,” Koinis-Mitchell said. 

Compared to children with well-controlled asthma, students with more daily asthma symptoms missed more days of school, completed fewer assignments and had lower quality work, researchers report in the Annals of Allergy, Asthma and Immunology. 

The biggest indicator of poor school performance, however was asthma control. 

Poorly controlled asthma appeared to have the worst impact on academic performance for Latino students, although black students also fared worse than white students with the breathing disorder. 

The study was not a controlled experiment designed to prove whether or how asthma might directly impact school outcomes. It also was not designed to prove to what extent students’ racial or ethnic background might directly impact the connection between asthma and things like school attendance or grades. 

Kids with asthma may take a variety of daily medications to control the breathing disorder and also carry rescue inhalers to help restore their breathing when they have an asthma attack. 

Children may struggle to manage the condition when their parents have difficulty getting them to doctor checkups, paying for care, or affording medications. Children in poor urban neighbourhoods may also be more likely to attend schools without a nurse on staff or formal support programmes in place to help kids manage asthma and other chronic health problems. 

And when kids have severe asthma, it can impact their health and school performance even when parents and children do not see obvious symptoms, said Dr Jason Lang, a researcher at Duke University School of Medicine in Durham, North Carolina, who was not involved in the study. 

“Good asthma control is not just important to reduce the risk for full-blown asthma attacks, but also because mild increases in asthma symptoms affect sleep quality, school attendance and academic performance,” Lang said by e-mail. “It’s hard for kids who are struggling with just minor breathing symptoms to concentrate and do their best in class.”