Stress related to having asthma might contribute to child behavioral problems

City children with asthma are more likely to have problems with behavior than children without the chronic respiratory problems, according to a University of Rochester Medical Center study in this month's Pediatrics.

Children with the worst asthma symptoms often have more than one behavior issue, such as being nervous and having trouble focusing on tasks. All of these behavior problems can interfere with learning.

"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. Or, on the other hand, behavior problems may make managing asthma symptoms more difficult," said lead author Jill Halterman, M.D., M.P.H., assistant professor at Golisano Children's Hospital at Strong.

Halterman, who conducted her study with the help of the Rochester-based Children's Institute, said that while it is difficult to determine if the asthma or the behavior trouble came first, it is apparent that both must be addressed when treating the child. The Children's Institute is an agency dedicated to developing and promoting effective prevention and early intervention programs, materials and best practices for children, families, schools and communities. Halterman serves as the agency's medical director.

The Rochester, N.Y.,-based study of incoming kindergarteners captured a more representative sample than previous studies on asthma and behavior problems because the children studied were not limited to those receiving treatment in clinical settings. Parents of 1,619 children were surveyed about their children's asthma symptoms and several different behaviors (EG: makes friends easily, fights with other children, concentrates well, is withdrawn).

Because the children in the study had not yet begun their formal schooling, and since behavior problems can impact academic achievement and adjustment, identification and treatment of problems at this young age could prevent school difficulties down the road.

"Parents of children with asthma should watch for problems in their child's behavior. Sure, kids are going to get into little tiffs, but if behavior problems become commonplace, parents should set appropriate limits and possibly ask for help from school counselors, teachers or their pediatrician," Halterman said. "Also, parents should make sure their children's health care providers are aware of the full extent of the children's symptoms so they receive the best possible treatment plan."