Preschoolers with persistent asthma symptoms
may be more likely to get into fights with their peers
or otherwise have more behavior problems than children
with less severe asthma, a study finds.
"These findings suggest a clear need for an early biopsychosocial
approach to care for vulnerable children with asthma,"
according to study author Dr. Jill S. Halterman, of the
University of Rochester School of Medicine in Rochester,
New York, and colleagues.
"The combined burden of asthma and behavior difficulties
could have a significant impact on children and their
families," Halterman stated.
The findings are based on an analysis of surveys completed
by parents of children in an urban school district who
were entering kindergarten. The surveys included questions
about the children's medical history, including whether
the child had asthma and whether the symptoms were persistent
or intermittent, and about the children's behavior.
Fifteen percent of the 1,619 children included in the
study experienced asthma symptoms such as wheezing, coughing,
or shortness of breath, and 8 percent had persistent symptoms,
which woke them from sleep more than one night a month
or required a visit to the emergency department on more
than three occasions during the previous year.
Overall, children with persistent asthma symptoms earned
the highest, meaning the worst, scores in negative peer
social skills, such as hurting others, bothering other
children, or fighting with other children, Halterman and
her team report in the journal Pediatrics.
These children also scored worse than those with intermittent
asthma symptoms -- or those with no asthma symptoms at
all -- in a measurement of their task orientation, such
as their level of concentration, and in a measurement
of their shy/anxious behavior, the report indicates.
The reason for the association between persistent asthma
symptoms and worse behavior is unclear.
"The stress related to having asthma might contribute
to behavioral problems because the family's focus on the
medical issue may make managing behavior more difficult,"
according to Halterman. "On the other hand," she speculated,
"behavior problems may make managing asthma symptoms more
difficult."
It's also unclear whether the persistent asthma symptoms
preceded or followed the children's worsened behavior.
Regardless of which comes first, Halterman advises parents
and teachers of children with asthma to "watch for problems
in their child's behavior."
"Sure, kids are going to get into little tiffs once in
a while, but if behavior problems become commonplace,
parents should set appropriate limits and possibly ask
for help from school counselors, teachers or their pediatrician,"
she stated.
SOURCE: Pediatrics, February 2006
