If your child often wheezes, coughs or finds it difficult to breathe, you or his doctor might suspect asthma. This chronic breathing disease is marked by excess mucus, muscle tightening or swelling of the lining in the airways. But while most children with asthma show signs before their fifth birthday, diagnosing it at that age can be difficult and requires several stages of evaluation to be sure.
Step 1
Watch your child for typical symptoms of asthma. These include repetitive coughing or wheezing, trouble breathing, loud or fast breathing, chest pain or tightness or a runny nose. The symptoms are especially suspect if they get worse at night or are triggered by play, exercise, cold air or exposure to allergens such as smoke, dust or pollen. However, for many young children who have episodes of wheezing that go along with colds or respiratory infections, the symptoms go away after they turn six years old as their airways grow larger.
Step 2
Check for common risk factors. Although not all children with asthma fit the bill, you may find that one or more genetic or environmental factors present in your child's life, which may increase her risk of developing the disease. Those include exposure to indoor or outdoor pollution, exposure to tobacco smoke while in the womb or during childhood and a family history of asthma, hay fever, allergies or eczema.
Step 3
Take your child to see his doctor for proper testing for asthma. The first thing she'll probably do is ask you about his symptoms and family medical history, which will include questions about hay fever, allergies and other health issues in your child or other family members, and what medications or supplements your child is taking. She may also ask about other diseases that interfere with the management of asthma, including reflux disease, sleep apnea or sinus infections.
Step 4
Take your child for a physical exam. This will include examination of her nose, throat, lungs and skin. If your child is younger than five, there is not much more the doctor can do, but if she's older, her doctor may also do a lung function test. This may be spirometry testing, which measures the volume and flow of air after your child takes a deep breath and then lets it all out, which is usually then repeated after using an inhaler. The other option is a peak flow rate measurement, which is a little easier for kids who are four to six years old. With this test, the child takes a deep breath, and then quickly blows it out as hard as possible into a peak flow meter. After doing this three times, the highest reading is recorded as the PEFR, or peak expiratory flow rate.
Step 5
Ask about further testing, which is sometimes done for children who are thought to have asthma based on the results of the spirometry or PEFR test. Challenge testing is done in a special asthma testing center, since emergency treatment may be required. This could be a cold air challenge or an exercise challenge, which puts your child in situations that cause her airways to narrow. After breathing cold air, or exercising for several minutes, she'll do another spirometry testing to see how those activities affected his breathing. It may also be recommended that he get other tests to make sure that it's asthma and not another condition causing the wheezing or coughing. This could be a chest X-ray, a barium swallow to test for acid reflux, skin or blood testing for allergies or a sweat chloride test for cystic fibrosis.
Step 6
Give your child any medications that the doctor wishes to try, and observe her reaction. Often a four-to-six-week trial of asthma medication will be prescribed as the last step of diagnosis to see how a child responds to the treatment.
