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Study links bad asthma with bad behavior

AsthmaFeb 16, 06

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 told Reuters Health.

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 said.

SOURCE: Pediatrics, February 2006.

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