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"&amp;lt;p&amp;gt;The approach to treatment of asthma in children in many ways is similar to &amp;lt;a href=&amp;quot;https://www.verywell.com/what-is-asthma-200585&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;1&amp;quot;&amp;gt;asthma treatment approaches for adults&amp;lt;/a&amp;gt;. However, kids&amp;amp;#39; asthma treatment is modified by age group, as recommended by the &amp;lt;a href=&amp;quot;http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;externalLink&amp;quot; data-ordinal=&amp;quot;2&amp;quot;&amp;gt;National Expert Panel Guidelines for Asthma Treatment&amp;lt;/a&amp;gt;. It also makes greater use of the stepwise approach to treatment of asthma, due to the greater variability in asthma status among kids.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;The Expert Panel stresses that the &amp;lt;a href=&amp;quot;https://www.verywell.com/what-is-your-asthma-severity-200638&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;3&amp;quot;&amp;gt;goal of asthma therapy&amp;lt;/a&amp;gt; in kids is to maintain long-term control of asthma with the least amount of medication and hence minimal risk for adverse effects. They also talk about preventing asthma from worsening, or progressing, in children.&amp;lt;/p&amp;gt;&amp;lt;h3&amp;gt;How Asthma Control Is Measured&amp;lt;/h3&amp;gt;&amp;lt;p&amp;gt;Asthma control is measured both by impairment and risk.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;&amp;lt;b&amp;gt;Asthma impairment reduction is defined as:&amp;lt;/b&amp;gt;&amp;lt;br/&amp;gt;&amp;lt;/p&amp;gt;&amp;lt;ul&amp;gt;&amp;lt;li&amp;gt;Chronic and troublesome &amp;lt;a href=&amp;quot;https://www.verywell.com/what-symptoms-say-about-your-asthma-200541&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;4&amp;quot;&amp;gt;asthma symptoms&amp;lt;/a&amp;gt;, such as coughing or feeling breathless in the daytime, in the night, or after exertion, are prevented.&amp;lt;/li&amp;gt;&amp;lt;li&amp;gt; &amp;lt;a href=&amp;quot;https://www.verywell.com/rescue-medications-how-they-work-201164&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;5&amp;quot;&amp;gt;Rescue inhalers&amp;lt;/a&amp;gt; are used for quick relief of asthma symptoms less than twice a week.&amp;lt;/li&amp;gt;&amp;lt;li&amp;gt;Healthy pulmonary function is maintained.&amp;lt;/li&amp;gt;&amp;lt;li&amp;gt;Usual activity levels, including school attendance and participation in sports and play activities, is possible.&amp;lt;/li&amp;gt;&amp;lt;li&amp;gt;Child and parents are satisfied with asthma care.&amp;lt;/li&amp;gt;&amp;lt;/ul&amp;gt;&amp;lt;p&amp;gt;&amp;lt;b&amp;gt;Asthma risk is reduced as follows:&amp;lt;/b&amp;gt;&amp;lt;br/&amp;gt;&amp;lt;/p&amp;gt;&amp;lt;ul&amp;gt;&amp;lt;li&amp;gt;Repeat asthma flare-ups are prevented, thus minimizing the need for emergency care or hospitalization.&amp;lt;/li&amp;gt;&amp;lt;li&amp;gt;Healthy lung growth occurs, with no worsening of airway function.&amp;lt;/li&amp;gt;&amp;lt;li&amp;gt;Effective medication treatment occurs without serious or bothersome &amp;lt;a href=&amp;quot;https://www.verywell.com/asthma-medication-side-effects-200593&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;6&amp;quot;&amp;gt;side effects&amp;lt;/a&amp;gt;.&amp;lt;/li&amp;gt;&amp;lt;/ul&amp;gt;Distinguishing between impairment and risk emphasizes the complex nature of asthma treatment and its effects on both quality of life, as well as physical functioning.&amp;lt;h3&amp;gt;Diagnosing Asthma in Kids Is the First Step&amp;lt;/h3&amp;gt;&amp;lt;p&amp;gt;Before asthma treatment in children can begin, however, a &amp;lt;a href=&amp;quot;https://www.verywell.com/difficulty-getting-asthma-diagnosis-200600&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;7&amp;quot;&amp;gt;diagnosis of asthma&amp;lt;/a&amp;gt; must be made. This is not as easy as it sounds. Asthma is often misdiagnosed in kids, which is what happens when their asthma-similar symptoms don&amp;amp;#39;t really add up to asthma. Or, they may also be underdiagnosed, when instead of the correct asthma diagnosis, they are labeled as having wheezy bronchitis, sinusitis, reactive airway disease, respiratory infections, or something else.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;Complicating factors is that children \u2013 especially very young ones \u2013 can&amp;amp;#39;t always communicate well enough about how they are feeling or what they are struggling with. Some pulmonary function tests that can help nail down an asthma diagnosis are also not able to be used in young children. Doctors often have to rely solely on their physical exam of the child and the parents&amp;amp;#39; observations. Or, in some cases, they may give asthma medications for a trial period to see what happens. If symptoms improve when taking asthma medications, an asthma diagnosis may be more likely.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;The problems with kids not getting the right diagnosis can be twofold:&amp;lt;/p&amp;gt;&amp;lt;ul&amp;gt;&amp;lt;li&amp;gt;Kids who are diagnosed in error as having asthma may be treated with the wrong medications for long periods of time and put at unnecessary risk.&amp;lt;/li&amp;gt;&amp;lt;li&amp;gt;Kids who DO have asthma do not receive the treatment they need to maintain healthy lung function. As a result, their airways get worse and quality of life declines.&amp;lt;/li&amp;gt;&amp;lt;/ul&amp;gt;&amp;lt;p&amp;gt;So, it&amp;amp;#39;s important that kids who have asthma be diagnosed correctly and started on treatment as soon as possible.&amp;lt;/p&amp;gt;&amp;lt;h3&amp;gt;Stepwise Approach to Asthma Treatment by Age Group&amp;lt;/h3&amp;gt;&amp;lt;p&amp;gt;When the Expert Panel Guidelines were updated in 2007, one of the changes was an emphasis on modifying the treatment approach for kids with asthma, based on their age group. The reason for this is based on a few factors. First of all, kids of different age groups may respond differently to medications or require them to be given differently, such as &amp;lt;a href=&amp;quot;https://www.verywell.com/how-to-use-a-nebulizer-p2-200785&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;8&amp;quot;&amp;gt;nebulizer&amp;lt;/a&amp;gt; vs. &amp;lt;a href=&amp;quot;https://www.verywell.com/breath-actuated-metered-dose-inhaler-201191&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;9&amp;quot;&amp;gt;inhaler&amp;lt;/a&amp;gt;. Secondly, scientific evidence proving safety and effectiveness of asthma medications is lacking in younger age groups. Third, lung function can not be assessed easily in younger age groups, making it harder to measure how well a drug is working. Asthma wheezing types may also vary by age group, and there may be other influencing factors as well.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;In general, daily, long-term &amp;lt;a href=&amp;quot;https://www.verywell.com/asthma-controller-medicines-201059&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;10&amp;quot;&amp;gt;asthma controller medicine&amp;lt;/a&amp;gt; is recommended for both of the age groups below. Depending on the degree of control, medication frequency and / or dosage may be stepped up to improve control. Now, let&amp;amp;#39;s look at each age group separately:&amp;lt;/p&amp;gt;&amp;lt;ul&amp;gt;&amp;lt;li&amp;gt; &amp;lt;b&amp;gt;Age 0 to 4 years&amp;lt;/b&amp;gt;&amp;lt;br/&amp;gt;Daily, long-term control therapy is recommended in this age group. It is aimed at reducing risk of &amp;lt;a href=&amp;quot;https://www.verywell.com/help-im-having-an-asthma-attack-200583&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;11&amp;quot;&amp;gt;asthma attacks&amp;lt;/a&amp;gt; and airway impairment in kids who had four or more episodes of &amp;lt;a href=&amp;quot;https://www.verywell.com/is-wheezing-a-common-asthma-symptom-for-adults-200529&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;12&amp;quot;&amp;gt;wheezing&amp;lt;/a&amp;gt; in the past year that lasted more than 1 day and affected sleep AND who have risk factors for developing persistent asthma. It should also be considered for reducing impairment in infants and young children who consistently require symptomatic treatment more than 2 days per week for a period of more than 4 weeks. Thirdly, controller medications may be used in infants and young children who have a second asthma flare-up needing &amp;lt;a href=&amp;quot;https://www.verywell.com/oral-steroids-for-your-asthma-201153&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;13&amp;quot;&amp;gt;oral steroids&amp;lt;/a&amp;gt; within 6 months to reduce their risk. Finally, asthma controller medicines may be used during seasons of increased risk, in kids who have had problems in the past, namely in relation to respiratory infections, the most common &amp;lt;a href=&amp;quot;https://www.verywell.com/understanding-asthma-triggers-201225&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;14&amp;quot;&amp;gt;trigger of asthma symptoms&amp;lt;/a&amp;gt; in young children.&amp;lt;br/&amp;gt;&amp;lt;br/&amp;gt;In these infants and young children, the decision to add, or step up, treatment will be based mainly on severity and frequency of observed symptoms.&amp;lt;/li&amp;gt;&amp;lt;li&amp;gt; &amp;lt;b&amp;gt;Age 5 to 11 years&amp;lt;/b&amp;gt;&amp;lt;br/&amp;gt;In kids this age, daily long-term controller therapy is recommended when the kids have been classified as having &amp;lt;a href=&amp;quot;https://www.verywell.com/mild-persistent-asthma-classification-diagnosis-and-treatment-3866924&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;15&amp;quot;&amp;gt;persistent asthma&amp;lt;/a&amp;gt;. At this age, the doctor weighs any possible risks of taking long-term asthma medicines, such as delayed growth, against the risks of not treating asthma. Studies have shown that the benefits definitely outweigh the relatively small risks, in most cases.&amp;lt;br/&amp;gt;&amp;lt;br/&amp;gt;In this age group, the decision to step up treatment is based on the following:&amp;lt;br/&amp;gt;&amp;lt;ul&amp;gt;&amp;lt;li&amp;gt;Symptoms, both in terms of frequency and severity&amp;lt;/li&amp;gt;&amp;lt;li&amp;gt;Asthma control scores (if available), which are simply a measure of the degree of control, based on tested survey tools that quantify various factors to come up with a score&amp;lt;/li&amp;gt;&amp;lt;li&amp;gt;&amp;lt;a href=&amp;quot;https://www.verywell.com/what-does-spirometry-measure-200933&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;16&amp;quot;&amp;gt;Pulmonary function testing&amp;lt;/a&amp;gt;&amp;lt;/li&amp;gt;&amp;lt;/ul&amp;gt;&amp;lt;/li&amp;gt;&amp;lt;/ul&amp;gt;Stepwise Treatment of Asthma The approach to treatment of asthma in children in many ways is similar to &amp;lt;a href=&amp;quot;https://www.verywell.com/what-is-asthma-200585&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;17&amp;quot;&amp;gt;asthma treatment approaches for adults&amp;lt;/a&amp;gt;. However, kids&amp;amp;#39; asthma treatment is modified by age group, as recommended by the &amp;lt;a href=&amp;quot;http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;externalLink&amp;quot; data-ordinal=&amp;quot;18&amp;quot;&amp;gt;National Expert Panel Guidelines for Asthma Treatment&amp;lt;/a&amp;gt;. It also makes greater use of the stepwise approach to treatment of asthma, due to the greater variability in asthma status among kids.&amp;lt;p&amp;gt;The Expert Panel stresses that the &amp;lt;a href=&amp;quot;https://www.verywell.com/what-is-your-asthma-severity-200638&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;19&amp;quot;&amp;gt;goal of asthma therapy&amp;lt;/a&amp;gt; in kids is to maintain long-term control of asthma with the least amount of medication and hence minimal risk for adverse effects. They also talk about preventing asthma from worsening, or progressing, in children.&amp;lt;/p&amp;gt;&amp;lt;h3&amp;gt;How Asthma Control Is Measured&amp;lt;/h3&amp;gt;&amp;lt;p&amp;gt;Asthma control is measured both by impairment and risk.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;&amp;lt;b&amp;gt;Asthma impairment reduction is defined as:&amp;lt;/b&amp;gt;&amp;lt;br/&amp;gt;&amp;lt;/p&amp;gt;&amp;lt;ul&amp;gt;&amp;lt;li&amp;gt;Chronic and troublesome &amp;lt;a href=&amp;quot;https://www.verywell.com/what-symptoms-say-about-your-asthma-200541&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;20&amp;quot;&amp;gt;asthma symptoms&amp;lt;/a&amp;gt;, such as coughing or feeling breathless in the daytime, in the night, or after exertion, are prevented.&amp;lt;/li&amp;gt;&amp;lt;li&amp;gt; &amp;lt;a href=&amp;quot;https://www.verywell.com/rescue-medications-how-they-work-201164&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;21&amp;quot;&amp;gt;Rescue inhalers&amp;lt;/a&amp;gt; are used for quick relief of asthma symptoms less than twice a week.&amp;lt;/li&amp;gt;&amp;lt;li&amp;gt;Healthy pulmonary function is maintained.&amp;lt;/li&amp;gt;&amp;lt;li&amp;gt;Usual activity levels, including school attendance and participation in sports and play activities, is possible.&amp;lt;/li&amp;gt;&amp;lt;li&amp;gt;Child and parents are satisfied with asthma care.&amp;lt;/li&amp;gt;&amp;lt;/ul&amp;gt;&amp;lt;p&amp;gt;&amp;lt;b&amp;gt;Asthma risk is reduced as follows:&amp;lt;/b&amp;gt;&amp;lt;br/&amp;gt;&amp;lt;/p&amp;gt;&amp;lt;ul&amp;gt;&amp;lt;li&amp;gt;Repeat asthma flare-ups are prevented, thus minimizing the need for emergency care or hospitalization.&amp;lt;/li&amp;gt;&amp;lt;li&amp;gt;Healthy lung growth occurs, with no worsening of airway function.&amp;lt;/li&amp;gt;&amp;lt;li&amp;gt;Effective medication treatment occurs without serious or bothersome &amp;lt;a href=&amp;quot;https://www.verywell.com/asthma-medication-side-effects-200593&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;22&amp;quot;&amp;gt;side effects&amp;lt;/a&amp;gt;.&amp;lt;/li&amp;gt;&amp;lt;/ul&amp;gt;Distinguishing between impairment and risk emphasizes the complex nature of asthma treatment and its effects on both quality of life, as well as physical functioning.&amp;lt;h3&amp;gt;Diagnosing Asthma in Kids Is the First Step&amp;lt;/h3&amp;gt;&amp;lt;p&amp;gt;Before asthma treatment in children can begin, however, a &amp;lt;a href=&amp;quot;https://www.verywell.com/difficulty-getting-asthma-diagnosis-200600&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;23&amp;quot;&amp;gt;diagnosis of asthma&amp;lt;/a&amp;gt; must be made. This is not as easy as it sounds. Asthma is often misdiagnosed in kids, which is what happens when their asthma-similar symptoms don&amp;amp;#39;t really add up to asthma. Or, they may also be underdiagnosed, when instead of the correct asthma diagnosis, they are labeled as having wheezy bronchitis, sinusitis, reactive airway disease, respiratory infections, or something else.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;Complicating factors is that children \u2013 especially very young ones \u2013 can&amp;amp;#39;t always communicate well enough about how they are feeling or what they are struggling with. Some pulmonary function tests that can help nail down an asthma diagnosis are also not able to be used in young children. Doctors often have to rely solely on their physical exam of the child and the parents&amp;amp;#39; observations. Or, in some cases, they may give asthma medications for a trial period to see what happens. If symptoms improve when taking asthma medications, an asthma diagnosis may be more likely.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;The problems with kids not getting the right diagnosis can be twofold:&amp;lt;/p&amp;gt;&amp;lt;ul&amp;gt;&amp;lt;li&amp;gt;Kids who are diagnosed in error as having asthma may be treated with the wrong medications for long periods of time and put at unnecessary risk.&amp;lt;/li&amp;gt;&amp;lt;li&amp;gt;Kids who DO have asthma do not receive the treatment they need to maintain healthy lung function. As a result, their airways get worse and quality of life declines.&amp;lt;/li&amp;gt;&amp;lt;/ul&amp;gt;&amp;lt;p&amp;gt;So, it&amp;amp;#39;s important that kids who have asthma be diagnosed correctly and started on treatment as soon as possible.&amp;lt;/p&amp;gt;&amp;lt;h3&amp;gt;Stepwise Approach to Asthma Treatment by Age Group&amp;lt;/h3&amp;gt;&amp;lt;p&amp;gt;When the Expert Panel Guidelines were updated in 2007, one of the changes was an emphasis on modifying the treatment approach for kids with asthma, based on their age group. The reason for this is based on a few factors. First of all, kids of different age groups may respond differently to medications or require them to be given differently, such as &amp;lt;a href=&amp;quot;https://www.verywell.com/how-to-use-a-nebulizer-p2-200785&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;24&amp;quot;&amp;gt;nebulizer&amp;lt;/a&amp;gt; vs. &amp;lt;a href=&amp;quot;https://www.verywell.com/breath-actuated-metered-dose-inhaler-201191&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;25&amp;quot;&amp;gt;inhaler&amp;lt;/a&amp;gt;. Secondly, scientific evidence proving safety and effectiveness of asthma medications is lacking in younger age groups. Third, lung function can not be assessed easily in younger age groups, making it harder to measure how well a drug is working. Asthma wheezing types may also vary by age group, and there may be other influencing factors as well.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;In general, daily, long-term &amp;lt;a href=&amp;quot;https://www.verywell.com/asthma-controller-medicines-201059&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;26&amp;quot;&amp;gt;asthma controller medicine&amp;lt;/a&amp;gt; is recommended for both of the age groups below. Depending on the degree of control, medication frequency and / or dosage may be stepped up to improve control. Now, let&amp;amp;#39;s look at each age group separately:&amp;lt;/p&amp;gt;&amp;lt;ul&amp;gt;&amp;lt;li&amp;gt; &amp;lt;b&amp;gt;Age 0 to 4 years&amp;lt;/b&amp;gt;&amp;lt;br/&amp;gt;Daily, long-term control therapy is recommended in this age group. It is aimed at reducing risk of &amp;lt;a href=&amp;quot;https://www.verywell.com/help-im-having-an-asthma-attack-200583&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;27&amp;quot;&amp;gt;asthma attacks&amp;lt;/a&amp;gt; and airway impairment in kids who had four or more episodes of &amp;lt;a href=&amp;quot;https://www.verywell.com/is-wheezing-a-common-asthma-symptom-for-adults-200529&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;28&amp;quot;&amp;gt;wheezing&amp;lt;/a&amp;gt; in the past year that lasted more than 1 day and affected sleep AND who have risk factors for developing persistent asthma. It should also be considered for reducing impairment in infants and young children who consistently require symptomatic treatment more than 2 days per week for a period of more than 4 weeks. Thirdly, controller medications may be used in infants and young children who have a second asthma flare-up needing &amp;lt;a href=&amp;quot;https://www.verywell.com/oral-steroids-for-your-asthma-201153&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;29&amp;quot;&amp;gt;oral steroids&amp;lt;/a&amp;gt; within 6 months to reduce their risk. Finally, asthma controller medicines may be used during seasons of increased risk, in kids who have had problems in the past, namely in relation to respiratory infections, the most common &amp;lt;a href=&amp;quot;https://www.verywell.com/understanding-asthma-triggers-201225&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;30&amp;quot;&amp;gt;trigger of asthma symptoms&amp;lt;/a&amp;gt; in young children.&amp;lt;br/&amp;gt;&amp;lt;br/&amp;gt;In these infants and young children, the decision to add, or step up, treatment will be based mainly on severity and frequency of observed symptoms.&amp;lt;/li&amp;gt;&amp;lt;li&amp;gt; &amp;lt;b&amp;gt;Age 5 to 11 years&amp;lt;/b&amp;gt;&amp;lt;br/&amp;gt;In kids this age, daily long-term controller therapy is recommended when the kids have been classified as having &amp;lt;a href=&amp;quot;https://www.verywell.com/mild-persistent-asthma-classification-diagnosis-and-treatment-3866924&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;31&amp;quot;&amp;gt;persistent asthma&amp;lt;/a&amp;gt;. At this age, the doctor weighs any possible risks of taking long-term asthma medicines, such as delayed growth, against the risks of not treating asthma. Studies have shown that the benefits definitely outweigh the relatively small risks, in most cases.&amp;lt;br/&amp;gt;&amp;lt;br/&amp;gt;In this age group, the decision to step up treatment is based on the following:&amp;lt;br/&amp;gt;&amp;lt;ul&amp;gt;&amp;lt;li&amp;gt;Symptoms, both in terms of frequency and severity&amp;lt;/li&amp;gt;&amp;lt;li&amp;gt;Asthma control scores (if available), which are simply a measure of the degree of control, based on tested survey tools that quantify various factors to come up with a score&amp;lt;/li&amp;gt;&amp;lt;li&amp;gt;&amp;lt;a href=&amp;quot;https://www.verywell.com/what-does-spirometry-measure-200933&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;32&amp;quot;&amp;gt;Pulmonary function testing&amp;lt;/a&amp;gt;&amp;lt;/li&amp;gt;&amp;lt;/ul&amp;gt;&amp;lt;/li&amp;gt;&amp;lt;/ul&amp;gt;&amp;lt;p&amp;gt;To some extent, the treatment of asthma in children (and adults) is somewhat of a trial and error process. The goal is always to give the l&amp;lt;a href=&amp;quot;https://www.verywell.com/asthma-medication-side-effects-200593&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;1&amp;quot;&amp;gt;east medicine necessary &amp;lt;/a&amp;gt;to keep symptoms under control. When control is not attained, however, doctors will first evaluate whether the &amp;lt;a href=&amp;quot;https://www.verywell.com/help-im-having-an-asthma-attack-200583&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;2&amp;quot;&amp;gt;asthma medication&amp;lt;/a&amp;gt; is being given correctly. This includes following exact instructions for the dosage, frequency and time of day of the medicine. It also includes looking at&amp;lt;a href=&amp;quot;https://www.verywell.com/rescue-medications-how-they-work-201164&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;3&amp;quot;&amp;gt; inhaler&amp;lt;/a&amp;gt; or nebulizer technique, as using both in kids can be challenging at times. Finally, one needs to examine if everything possible in &amp;lt;a href=&amp;quot;https://www.verywell.com/understanding-asthma-triggers-201225&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;4&amp;quot;&amp;gt;trigger avoidance &amp;lt;/a&amp;gt;is being done.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;The doctor will also consider whether &amp;lt;a href=&amp;quot;https://www.verywell.com/less-common-causes-of-wheezing-200648&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;5&amp;quot;&amp;gt;other health problems&amp;lt;/a&amp;gt;, such as sinusitis, may be interfering with asthma control. And finally, efforts at avoiding environmental triggers must be looked at. When a child continues to come into &amp;lt;a href=&amp;quot;https://www.verywell.com/understanding-asthma-triggers-201225&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;6&amp;quot;&amp;gt;daily contact with triggers&amp;lt;/a&amp;gt;, &amp;lt;a href=&amp;quot;https://www.verywell.com/what-is-your-asthma-severity-200638&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;7&amp;quot;&amp;gt;asthma control &amp;lt;/a&amp;gt;will be challenged. It should be emphasized too that every child should have a written, personalized &amp;lt;a href=&amp;quot;https://www.verywell.com/asthma-action-plan-sample-201042&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;8&amp;quot;&amp;gt;Asthma Action Plan&amp;lt;/a&amp;gt; that guides parents on a day to day basis with managing their child&amp;amp;#39;s asthma.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;When stepping up &amp;lt;a href=&amp;quot;https://www.verywell.com/what-is-asthma-200585&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;9&amp;quot;&amp;gt;treatment&amp;lt;/a&amp;gt;, or &amp;lt;a href=&amp;quot;https://www.verywell.com/steps-towards-better-asthma-control-201125&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;10&amp;quot;&amp;gt;addressing the other factors&amp;lt;/a&amp;gt; discussed above, doesn&amp;amp;#39;t improve the child&amp;amp;#39;s health status, then a referral to an &amp;lt;a href=&amp;quot;https://www.verywell.com/asthma-doctor-and-care-for-children-201021&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;11&amp;quot;&amp;gt;asthma specialty doctor&amp;lt;/a&amp;gt; is strongly encouraged, particularly in the presence of any of the following conditions:&amp;lt;/p&amp;gt;&amp;lt;ul&amp;gt;&amp;lt;li&amp;gt;Control is difficult to achieve.&amp;lt;/li&amp;gt;&amp;lt;li&amp;gt;A child in the 0 to 4 years age group requires step 3 or higher care.&amp;lt;/li&amp;gt;&amp;lt;li&amp;gt;A child in the 5 to 11 years age group required step 4 or higher care.&amp;lt;/li&amp;gt;&amp;lt;li&amp;gt;The child has an &amp;lt;a href=&amp;quot;https://www.verywell.com/help-im-having-an-asthma-attack-200583&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;12&amp;quot;&amp;gt;http://asthma.about.com/od/asthmabasics/a/Asthma_handle.htm&amp;lt;/a&amp;gt;asthma flare that requires hospitalization.&amp;lt;/li&amp;gt;&amp;lt;li&amp;gt;Allergy tests or &amp;lt;a href=&amp;quot;https://www.verywell.com/imunotherapy-what-you-need-to-know-201152&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;13&amp;quot;&amp;gt;allergy shots&amp;lt;/a&amp;gt; are to be considered, due to suspicions of allergic factors.&amp;lt;/li&amp;gt;&amp;lt;/ul&amp;gt;&amp;lt;h3&amp;gt;Physician Follow-up Care for Kids With Asthma&amp;lt;/h3&amp;gt;&amp;lt;p&amp;gt;Once control has been achieved, the Expert Panel still recommends that kids be seen by their doctors every 1 to 6 months. If a future step-down in treatment is planned, then the child should be seen at 3-month intervals until this occurs. Step-down should be considered if a child has been under control for at least 3 months.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;&amp;lt;sub&amp;gt;Source: &amp;lt;/sub&amp;gt;&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;National Heart Lung and Blood Institute. &amp;amp;#34;Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma.&amp;amp;#34; &amp;lt;a href=&amp;quot;http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;externalLink&amp;quot; data-ordinal=&amp;quot;14&amp;quot;&amp;gt;NHLBI Guidelines for the Diagnosis and Treatment of Asthma&amp;lt;/a&amp;gt;. Accessed January 31, 2016.&amp;lt;/p&amp;gt;"^^<http://www.w3.org/2001/XMLSchema#string>
<https://www.verywell.com/treatment-of-asthma-in-children-200739>