You can almost smell them from here: newly sharpened pencils, chalk dust, and new clothes. It's back to school time across the land - an exciting time of transition, change and growth! For the 5 million kids and teens who have asthma or allergies, time at school also can present a unique set of challenges. To help you better prepare for the school year ahead, here is some of the latest medical data about asthma and allergies as it relates to kids and school.

Quality of sleep impacts school performance.

Studies show that kids and teens, whose nighttime sleep is disrupted by asthma symptoms, generally miss more school days and have greater difficulty with schoolwork during the day than their friends without asthma. Missed sleep due to nighttime asthma can cause children to have poor recall memory, lack of concentration and mood disorders.

Regular nighttime asthma flare-ups may be a sign that asthma is not under control and a different treatment approach may be needed. One cause for an increase in asthma symptoms during the night may be common household asthma triggers: dust mites and pet dander, for instance, are much more prevalent at home.

If you or your child gets up regularly during the night to handle problems with asthma, talk with your health care provider about medications that work overnight to reduce asthma symptoms. Also be sure to double-check the bedroom for possible allergy triggers. More sleep and prolonged deep sleep significantly improves students' memory capabilities.

Couch potatoes and web heads run a greater risk of developing asthma.

Are the kids in your house spending a lot of time in front of the computer and television? If so, they may be increasing their chances of getting asthma, according to new medical studies.

Over the last 30 years, physical activity among children has decreased dramatically. Back then, kids often played outside for several hours each day plus rode a bike or walked to school. These days many children spend much more time on indoor entertainment activities and they tend to travel everywhere by car. The result? Kids of all ages today weigh more than their counterparts in the past, even though they are eating less.

Recent research shows that obesity is associated with having asthma. (Obese people are at least 20 percent heavier than recommended for their height, age and sex.) Overweight kids may be two to three times more likely to develop asthma than their friends of normal weight. Scientists speculate that an inactive lifestyle, increased exposure to indoor allergens from being indoors most of the time and increased body weight, which puts additional pressure on the chest, may be contributing factors to the increasing incidence of asthma.

Teenagers don't stick to their asthma treatment plans.

A recent study conducted by the American Lung Association shows that teens with asthma often take less than half of their prescribed medications or don't take them at all. In another European-based study, researchers found that 40 percent of children with asthma don't use their controller medications regularly. When young people with asthma fail to use their medications properly, they often perform below par in school and miss out on sports and social activities.

Parents Helping Kids Manage Asthma

Asthma is a difficult disease to manage. Not only do people with asthma often have to make alterations to their lifestyles to avoid certain asthma triggers, they also have to learn how to juggle and use many medications.

For children this can be a challenge, especially if they don't receive their family's full support. A recent survey in five European countries of more than 600 families who have children with asthma, showed that many of these parents needed to be more involved in their child's asthma care. Results show that many parents still need to brush up on their asthma management knowledge such as:

• Learning how to properly administer their child's medications.
• Stressing to children that they need to take their medications exactly as prescribed.
• Making sure their child has medications on trips away from home.
• Understanding how to prevent an asthma attack.

To learn more about all of these issues, check out the asthma education resources provided through AAFA and resources on Vivra's BreathingZone.com.

Schools nurses and clinics can handle most asthma episodes. If asthma symptoms flare up while kids are at school, early intervention by school-based health care workers can often get students back to class-instead of sending them to the emergency room.

A 1998 review of student charts in two high schools found that 95 percent of students who visited the health center for asthma complaints went back to class the same day-and nearly 30 percent of those students needed a nebulizer treatment. Educated clinic personnel can check pre-and post-treatment peak flows, provide necessary medication and assess what care is needed.

Tips for Children at School with Asthma

• Find out if your child's school allows them to keep inhaled medications in their possession. AAFA supports a written medication policy that allows safe, reliable, and prompt access to medications in the least restrictive way during all school-related activities and self-managed administration of medication (including consideration of allowing students to carry and self-administer medications) consistent with the needs of the individual child and the safety of others.
• If your child has exercise induced asthma, make sure that coaches and gym teachers are familiar with your child's condition and doctor's recommendations regarding pretreatment and acute or emergency asthma treatment. Include phone numbers to call with questions or in case of an emergency.
• Talk to your child about knowing his or her own limits. Children need to know that it is important to respond to their asthma symptoms immediately and not ignore an asthma attack.
• Information and communication are the most important tools in effective management of allergic disorders.

Tips for Children at School with Allergies

• Before school starts, tour the school to identify potential asthma/allergy triggers in the classrooms. Ask staff about school policies regarding foods brought into the classroom and animals in the school.
• Sometimes children are not able to express in words that their allergies are acting up. Monitor bouts of irritability, temper tantrums, or decreased ability to concentrate in school-symptoms of allergic irritability syndrome are often caused by nose, ear and sinus congestion in allergic children.
• Inform staff of the child's allergies. If symptoms flare up at school, it may be the result of exposure to environmental allergens such as animal dander brought in on the clothing of pet-owning classmates or mold growth in the school building. Try to understand when and where symptoms worsen and work with the school to implement control measures.
• Food allergic children who have been prescribed epinephrine should provide the school with an identification sheet with the child's name, photo, and specific allergy for distribution to appropriate personnel. Staff should be taught how to administer an epinephrine shot in the event of an emergency.
• Parents of food allergic children should work with the school to establish a no food-trading policy.

Are you using your Student Action Card?

This one-page form provides space to describe your child's asthma triggers, medications and emergency directions for school personnel or day care workers. Single copies available free from AAFA .  You can also find teacher information sheet at http://www.breathingzone.com/resources/teacher.asp.

The impact of asthma on school performance can be notable. In research studies, children with asthma were twice as likely to be in special education programs or struggle with attention, behavior, emotional and communication issues. Common sense and medical research both suggest that such problems may result because the child is not feeling well. Medication side effects, lack of sleep, depression from "being different" or a general sense of malaise (feeling tired) because of allergies or asthma-all can detract from a child's ability to concentrate at school and perform at maximum capability.

Best advice? Fine-tune your asthma or allergy management plan to handle the ups and downs of school. Be ready to handle the stress of exams and term papers, sports and social events, or even a lost night's sleep. Teachers, students and parents can work together to "attack" effects of allergies and asthma.

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