Newly Diagnosed Asthmatic Children: What To Know
Asthma is generally known, but not always understood. It affects over six million children in the United States, making it the leading chronic disease in children. Despite this statistic, pediatric asthma often goes undiagnosed – it’s usually confused with other respiratory conditions like bronchiolitis.
Having a newly diagnosed child not only means a new routine and lifestyle for the child, but for the whole family. The best treatment plans also include addressing the mental health and wellbeing of the parents.
Here are our recommendations for how to prepare for a new diagnosis in your child:
Three Phase Model For Coping
This model, shared by My Child is Diagnosed with Asthma, Now What? Motivating Parents to Help Their Children Control Asthma, breaks down all of the complex emotions that initially come with a life-changing diagnosis for your child. The phases are broken into three categories, A) Emotional Crisis; B) Facing Reality; and C) Reclaiming Life.
Emotional Crisis
Dominant emotions may include:
- Denial
- Grief
- Self-doubt and powerlessness
- Anxiety
- Guilt
Facing Reality
- Parents re-introduce daily routines and regain normalcy. Asthma education is used to teach asthma management strategies.
- Parents begin to develop coping skills and use trial and error to determine what strategies are most effective for their child’s illness management.
Reclaiming Life
As parents develop coping skills, they gain confidence to care for their child and integrate the fact that they have a child with a chronic illness into their lifestyle. Parents develop family routines that incorporate illness management and help them adhere to medication protocols.
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Family rituals, such as an established bedtime or dinner routine, can help to reduce anxiety and restore a sense of organization and stability to the family. The publication emphasizes that the purpose of this three phase model is not to move through it linearly, because things like grief often happen cyclicly. Instead, it’s recommended that parents expect to move through this periodically.
Asthma itself is considered cyclical, with triggers having different seasons of high and low risk phases, due to environment or weather changes. As the symptoms of your child’s asthma ebbs and flows, it’s important to flow through the three phase model the same way when needed.
Asthma Self- Regulation Theory
The study, My Child is Diagnosed with Asthma, Now What? Motivating Parents to Help Their Children Control Asthma defines asthma self-regulation as:
A person’s knowledge, confidence, and skills in managing asthma on their own after they have been given a treatment regimen. The development of skills needed to effectively regulate asthma follows a sequential four-phase process: 1) Asthma Avoidance; 2) Asthma Acceptance; 3) Asthma Compliance; and 4) Asthma Self-Regulation.
Asthma Avoidance
Parents in this phase have trouble accepting the reality of their child having a chronic illness, and instead may view it as fixable, or temporary.
In this stage, it's important that parents understand the serious nature of asthma, and that there are underlying causes that need to be considered, not just addressing acute attacks. Simply restricting the child’s activity is a sign of uncontrolled asthma, but continuously monitoring asthma is the best way to stay ahead of the illness.
Asthma Acceptance
Parents now recognize that asthma is chronic, and that some regular treatment is necessary. They accept that it is potentially life-threatening, but understand that ongoing treatment is their new normal.The goal in this stage is for parents to understand how medications function and to track symptoms with diaries, checklists, and/or graphs. The publication explains that:
"Parents in this phase need to receive educational messages that include, a) attacks are a sign that asthma symptoms are out of control, b) quick-reliever medications do not prevent symptoms, c) symptoms are a sign of inflammation, d) controller medications reduce inflammation, and e) it is important to monitor symptoms to judge whether the treatment regimen is working.”
Asthma Compliance
In this phase, parents understand the chronic nature of asthma, and have taken steps to understand treatment. They are able to track and monitor medications and have learned how to best manage asthma on a day to day basis.
However, because they lack knowledge in how to alter medications preventatively, they get overwhelmed by the process and often lean too heavily on the medical provider.
In this phase, the focus shifts to developing an asthma action plan with their medical providers, and strengthening their discernment and ability to make sound decisions during flare-ups or acute attacks.
Asthma Regulation
The PubMed Central Journal describes phase 4 parents as:
"Parents who develop self-efficacy to adjust treatment plans in order to regulate asthma progress graduate to Asthma Self-Regulation. They manage asthma proactively by using controller medications and controlling environmental triggers. These parents begin to actively remove triggers from their home. They also adhere to stepped medical plans that allow for medication adjustments in response to changing conditions without heavy reliance on the medical provider."
Parents in this stage need to know how to indicate and adjust their child’s treatment plan. They also need to learn how to identify and remove allergens in the home, especially in the child’s bedroom.
Get Connected With The School Nurse
According to A Review of School Nurses’ Self-efficacy in Asthma Care, the six million children diagnosed with asthma account for almost 14 million missed school days. As a result, schools have made great efforts to better educate school nurses about asthma, helping parents and families monitor and create benchmarks for managing their diagnosis while at school.
School nurses can provide assessment, advice, support, and referral. The nurse has the ability to offer asthma education to students, parents, and faculty as well as collaborate with community health providers to deliver asthma action plans and medication orders. They can advocate reducing environmental triggers in the classroom, and can act as an intermediary between parents, staff, and health care providers. They can also encourage normal activity levels for the student, such as at school and sporting events.
Have An Asthma Action Plan
To mitigate overwhelm, it’s important to have a one page document that includes all important information ready and available for when flare-ups happen. An asthma action plan includes all of your personal information, doctors, medications, to help you easily log a flare-up using a three zone system.
Green Zone (Doing Well):
No symptoms (coughing, wheezing, or chest tightness). Continue daily controller medications as prescribed.
Yellow Zone (Caution):
Increased symptoms such as coughing, wheezing, or nighttime awakening. Follow specific instructions for increasing reliever medication (e.g., rescue inhaler every 4–6 hours).
Red Zone (Danger):
Severe symptoms, difficulty breathing, or little to no improvement after using rescue medication. Seek emergency medical attention or call 911 immediately.
Key Implementation Steps
Actionable Documentation
Obtain an official form from your doctor or a reputable health organization. To access the Breathe New Hampshire Asthma Action Plan, contact us at info@BreatheNH.org
Accessibility
Keep a physical copy at home, a digital version on your phone, and provide copies to all school staff and childcare providers. Update the plan annually or whenever there is a change in medication or symptom frequency.
While a new diagnosis can be an overwhelming experience, it is normal to feel uncertain and to ask for help. There is support and resources at your disposal to make you feel informed and prepared. The change in lifestyle might not be something you had hoped for, but there is a way forward!
Disclaimer: This information is for educational purposes and does not constitute medical advice. Always consult a licensed healthcare professional for diagnosis and treatment