Parents' expectations influence children's asthma

According to new research children with asthma whose parents have high expectations for their ability to function normally, are less likely to have symptoms than other children dealing with the condition.

A new study by researchers at Harvard Medical School, Harvard Pilgrim Health Care and Boston University, has found parents' expectations and perceptions are key factors which influence how well their children's asthma is controlled, and how effectively they use medications.

Dr. Tracy Lieu, the study's senior author says raising parents' expectations for how well their children can do with asthma may be one of the keys to reducing racial/ethnic disparities in asthma outcomes.

The research also revealed that children are more likely to use asthma controller medications appropriately if they have a routine for taking medicine and if their parents clearly understand how well symptoms can be controlled.

Asthma is one of the most common childhood chronic illnesses and the most frequent cause of children's hospitalization and racial and ethnic minorities and families of low socioeconomic status are at increased risk of having poorly controlled asthma.

For the study, the investigators surveyed more than 700 parents of children aged 2 to 12 years with persistent asthma who received care at Neighborhood Health Plan and Harvard Vanguard Medical Associates in Boston.

Parents were asked how well they believed their child's symptoms could be controlled, how asthma would or would not limit their child's activities and health, and about their child's actual asthma symptoms and also about other competing family priorities such as financial and job concerns, neighborhood safety, family relationships and their own health.

It was found that children were more likely to have troublesome symptoms if their parents had low expectations for how well their asthma could be controlled and were also more likely to have poorly controlled symptoms if there was no set time or routine for taking asthma medication.

Also related to worse asthma control were concerns about other family issues and lack of parental knowledge about asthma with some parents mistakenly believing that asthma is an intermittent rather than chronic condition, that two days of symptoms per week was adequate control, and that medication use was necessary only when their child had symptoms or not at all - daily medication use is recommended for children with persistent asthma.

The investigators believe it is important that doctors and health care personnel identify and work with parents who have low expectations about asthma control and educate them about treatments that can improve their child's condition.

The research was funded by the National Institute of Child Health and Human Development and appears in the current issue of Pediatrics.