Children may spend long periods in daycare or school settings, so it is very important that adult supervisors in these environments are aware of a child’s asthma action plan. Parents should request that a child’s physician compose an asthma action plan specifically written for school or daycare officials. This should include the following information:

• A list of the child’s asthma triggers (e.g., dust, pollen, exercise).
  
  
• A list of symptoms typically experienced by the child prior to and during an asthma attack (e.g., wheezing, coughing, tightness in chest, difficulty breathing).
  
  
• A list of the child’s medications and the proper methods for taking them.
  
  
• Times medications should be used and at what doses.
  
  
• Which medications the child should take when symptoms appear.
  
  
• Which medications may be necessary before physical activities, such as gym class or recess.
  
  
• Whether or not the child is capable of self-administering medication, and if so, which medications. Some older children are able to manage their own day-to-day medications, while others are too young to handle this responsibility.
  
  
• Whether or not the child is capable of reliably reporting their asthma symptoms to a caregiver.  
  
  
• Whether or not the child is capable of alerting a caregiver when they need medication.
  
  
• Times a peak flow meter should be used.
  
  
• What to look for in peak flow meter readings.
  
  
• Parent or guardian contact information. This includes the street address and home phone number, as well as cell phone numbers and work numbers. Additional contact information of family or close friends should be included in case the parents or guardians cannot be reached.
  
  
• Emergency phone numbers. This should include the name and number of the child’s physician, as well as a name and number of someone who can be called if the physician is unavailable. After-hours numbers should be included.

A child’s asthma action plan must be straightforward and comprehensive enough that an adult can quickly understand what to do if the child is having a sudden attack. The plan should be written with the assumption that the parents and child will be unable to explain any of the details on the plan.

Any adult who will regularly be in charge of a child should have a copy of their asthma action plan. This includes:

• School principal
• Teachers
• School nurse
• Coaches
• Daycare instructors
• Babysitters
• Dorm monitors (if the child is at a boarding school or college)

At the beginning of each school year or new daycare relationship, parents should contact and possibly meet officials to explain both the child’s asthma action plan and the role officials should take when symptoms appear. All caregivers likely to have contact with the child – including teachers, coaches, nurses and others – should be included in the meeting if possible. 

Possible meeting topics include:

• Factors in a school setting that can trigger asthma symptoms, such as classroom pets, chalk dust and foods to which the child may be allergic, and steps to reduce the child’s exposure to them.
  
  
• How to use a peak flow meter and what the readings indicate.
  
  
• Plans for making up missed schoolwork in the event that asthma symptoms force a child to miss days regularly.

How the child’s medication will be stored at the school. Some schools allow children to carry their own medication, while others have rules that a teacher or other faculty member must hold on to the medication for the child.

Encourage the school staff – particularly teachers – to treat the child just like other students. It is important for children’s self-esteem that attention not be unnecessarily drawn to their asthma and medication needs. Children may feel self-conscious about taking medication at school, so it may be a good idea to work with school officials to construct a plan that allows the child to take medication discretely.

It is important to keep the lines of communication open with school officials so adjustments can be made to the asthma action plan as warranted.