As my two asthmatics get older they are in more and more situations where mom and dad might not be nearby to deal with an asthma attack. This is when it becomes important for them to be able to recognize an attack, notify the appropriate adult or administer their rescue medication on their own.
Admittedly, I have not been all that excited about the thought of my children having to administer their own medication. It goes against all of my overprotective instincts. Unfortunately (or fortunately for them), I can't follow them around all day, inhaler in hand. Thankfully, our school nurse was a godsend last school year and helped to teach my girls how to use their inhalers themselves. We continued this throughout the summer to ensure they were comfortable with their medications before it is needed in an emergency.
There are no cut and dry answers for what age is appropriate for teaching self-medicating. It depends on a number of factors. Answering these questions can help to determine if your child is mature enough to take on some of the responsibility of their asthma medications themselves.
Can your child identify and avoid triggers?
If your child does not understand their asthma or what can trigger it they might not be ready to carry their own medication. Teaching your child all of their triggers and how to avoid them is essential for empowering them to deal with asthma. As parents to asthmatic children, we often find ourselves removing triggers without filling our children in on what we are doing and why. For example, if you skip a cookout because the smoke from the barbecue always triggers an attack for your child explain to them that smoke is one of their triggers. The more the child knows the more they can avoid those things on their own.
Can your child identify and treat an attack quickly?
This may sound strange but there are many children, especially younger ones, that don't really know when they are having the warning signs for an asthma attack. Sometimes an attack can start as a cough, mild shortness of breathe or even a tickle in the throat. If the child is not able to connect those things to a potential attack or if they frequently ignore the signs then they are probably not ready to carry their own medications. Children with asthma should be able to identify their symptoms and quickly get to their medication. Seconds count with asthma so it needs to be clear that waiting until they are done with a game or project at school is not acceptable.
Can your child demonstrate proficiency in using asthma medications?
Proficiency in using asthma medications may be hard for a parent to measure. Your pediatrician or school nurse can help ensure that your child is using their medication correctly. One of the things you may also want to start with is teaching them to use their Peak Flow Meter and record the numbers. We also worked on allowing our girls to be in charge of their preventative or maintenance medication. By monitoring the count on the inhaler we could double check that they used it and remind them if they forgot. It was a good way to get them into the habit of using their inhaler on their own without the stress of needing rescue medication for an actual attack.
Can you trust your child to tell an adult once they've used their medication?
Your child may be able to use their medication on their own, but they also need to let their teacher, school nurse or other responsible adult know if they have had to use their medication. It is also important that you as a parent are also made aware of the number of times a rescue inhaler is used. If your child's rescue inhaler has a counter on it then you can keep track fairly easily. These numbers are important to discuss with your child's pediatrician or pulmonologist. Overuse of the rescue inhaler may indicate that your child's asthma is not well-controlled.
Once you've determined that your child is able to self-medicate as needed it doesn't mean that you can just toss their medication in their backpack and send them to school. All 50 states have laws that allow children with asthma to carry their inhalers. However, you must have a prescription for the medication and a note from the physician stating your child is able to use their medication correctly on file with the school. Many times the school will require backup medications to be on hand at the school as well. Backup medication is a smart plan just in case your child misplaces their medication.
If your child's school refuses to let them carry their inhaler you have some recourse. Talk with the school nurse and make sure you have the appropriate paperwork submitted as well as a note from your child's physician on file with the school. Oftentimes the nurse can help advocate for you by ensuring your child is proficient in self-medicating. Should the school still refuse you may want to print out your state's law and take it to the school board.
Teaching our children to carry and administer their own medication can be scary. Empowering children with asthma to take control of their illness can actually end up being safer in the long run because they can carry their inhaler with them throughout the day. This makes for quicker responses to attacks in children who are deemed mature enough to self-medicate. This is especially important when children will be in situations without their parents or in a school that doesn't have a school nurse. If your child is not ready to handle these medications on their own, talk with your pediatrician and school nurse. They can give you lots of tips for helping your children be more comfortable with their medications.
_Jennifer has a bachelor's degree in dietetics as well as graduate work in public health and nutrition. She has worked with families dealing with digestive disease, asthma and food allergies for the past 12 years. Jennifer also serves the Board of Directors for Pediatric Adolescent Gastroesophageal Reflux Association (PAGER). _
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