Treating asthma in children ages 12 and older
Treating asthma in children ages 12 and older requires different steps than in younger children. Get tips on symptoms, medications and using an asthma action plan.By Mayo Clinic Staff
Asthma is ongoing (chronic) inflammation of airways in the lungs. This inflammation makes the airways vulnerable to episodes of difficult breathing (asthma attacks). Common triggers of attacks include allergies, colds and exercise.
Asthma in older children can interfere with sleep, school, sports and social activities. The emotional, social and developmental changes associated with adolescence may sometimes complicate disease management.
Asthma management depends on controlling inflammation with drugs, avoiding triggers when possible and using medications to treat asthma attacks. Your child can learn to minimize symptoms by following a written action plan developed with your child's doctor to monitor and adjust treatment as necessary.
Asthma symptoms in children ages 12 and older
Common signs and symptoms of asthma in children ages 12 and older may include:
- Wheezing, a high-pitched, whistle-like sound when exhaling
- Trouble breathing or shortness of breath
- A tight, uncomfortable feeling in the chest
The severity and patterns of symptoms may vary:
- Worsening of symptoms at night
- Short periods of coughing and wheezing between periods of time with no symptoms
- Frequent or chronic symptoms with episodes of worse wheezing and coughing
- Seasonal changes based on prevalent infections or allergy triggers
Asthma symptoms may be triggered or worsened by certain events:
- Colds or other respiratory infections
- Exposure to allergy-causing agents (allergens), such as dust, pet dander or pollen
- Activity or exercise
- Exposure to cigarette smoke or other airborne irritants
- Strong emotional reactions, such as crying or laughing
- Changes or extremes in weather
Diagnosis of asthma
A diagnosis of asthma is based primarily on a physical examination, a medical history and a test of how well lungs work.
Your doctor will likely ask a number of questions, such as the following:
- Is there a family history of asthma?
- How often do symptoms occur?
- Does coughing wake your child at night?
- Do the symptoms accompany a cold or are they unrelated to colds?
- Do they occur with exercise?
- Does your child avoid normally enjoyed activities because of breathing difficulties?
- How often do episodes of breathing difficulty occur?
- How long do they last?
- Has your child needed emergency care for breathing difficulties?
- Does your child have any known pollen, dust, pet or food allergies?
- Is your child exposed to cigarette smoke or other airborne irritants?
The primary diagnostic test is performed with a device called a spirometer, which measures how much air and how quickly air is exhaled. The results of the test indicate how well the lungs function even when signs and symptoms are not present.
Your doctor may follow up the initial spirometry test with a treatment test. Your child inhales a short-acting asthma drug and then repeats the lung function test with the spirometer. An improvement in results of a second test with the spirometer may help confirm a diagnosis of asthma.
Your doctor may recommend an allergy skin test or allergy blood test if cats, dogs, dust mites, mold or pollen are suspected asthma triggers.
Oct. 18, 2016
- Bitsko MJ, et al. The adolescent with asthma. Paediatric Respiratory Reviews. 2014;15:146. Accessed Sept. 8, 2016.
- Adkinson NF, et al. Diagnosis of asthma in infants and children. In: Middleton's Allergy: Principles and Practice. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2014. http://www.clinicalkey.com. Accessed Aug. 3, 2016.
- Expert panel report 3 (EPR3): Guidelines for the diagnosis and management of asthma. Bethesda, Md.: National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/guidelines/asthma/. Accessed Aug. 3, 2016.
- Fanta CH. An overview of asthma management. http://www.uptodate.com/home. Accessed Sept. 8, 2016.
- Questions and answers: New safety requirements for long-acting asthma medications called long-acting beta agonists (LABAs). Food and Drug Administration. http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm200719.htm. Accessed Sept. 12, 2016.
- Updated information on leukotriene inhibitors: Montelukast (marketed as Singulair), zafirlukast (marketed as Accolate), and zileuton (marketed as Zyflo and Zyflo CR). Food and Drug Administration. http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/DrugSafetyInformationforHeathcareProfessionals/ucm165489.htm. Accessed Sept. 12, 2016.
- Allergy shots (immunotherapy). American Academy of Allergy, Asthma & Immunology. https://www.aaaai.org/conditions-and-treatments/treatments/allergy-shots-(immunotherapy). Accessed Sept. 12, 2016.
- Spacers and valved holding chambers (VHCs) for use with metered dose inhalers (MDIs). American Academy of Allergy, Asthma & Immunology. https://www.aaaai.org/conditions-and-treatments/library/asthma-library/spacers-asthma. Accessed Aug. 4, 2016.
- Inhaled asthma medications. American Academy of Allergy, Asthma & Immunology. https://www.aaaai.org/conditions-and-treatments/library/at-a-glance/inhaled-asthma-medications. Accessed Sept. 12, 2016.
- Sadof M, et al. Adolescent asthma: A developmental approach. Current Opinions in Pediatriacs. 2011;23:373. Accessed Sept. 8, 2016.
- Peak flow meter. American Academy of Allergy, Asthma & Immunology. https://www.aaaai.org/conditions-and-treatments/library/at-a-glance/peak-flow-meter. Accessed Sept. 8, 2016.