Children and Adult Perceptions of Childhood Asthma

OBJECTIVE: To explore children's and parents' assessment of children's asthma. DESIGN: Prospective 2-month cohort study in which children and parents were reviewed at baseline and 1-month intervals. SETTING: Mid-sized, English-speaking, industrial community serving an urban and regional rural population. PATIENTS OR PARTICIPANTS: Fifty-two children, 7 to 17 years old, with a wide range of asthma severity, and their parents. INTERVENTIONS: We offered patients with inadequately controlled asthma additional inhaled steroid. MAIN OUTCOME MEASURES: Children and parents provided global ratings of change in childhood symptoms and children completed spirometry and the Paediatric Asthma Quality of Life Questionnaire at clinic visits. Patients recorded peak flow rates, symptoms, and medication use in a daily diary. The diary symptom report, medication use, and spirometry were combined to form an asthma control score. RESULTS: In children younger than 11, children's global rating of change in symptoms correlated strongly with changes in quality of life (0.54 to .67) but not with measures of airway caliber or asthma control, while parents' global ratings did not correlate with children's quality of life but showed moderate correlations with airway caliber (0.29 to .48) and asthma control (0.50). In children over the age of 11, correlations with all clinical variables were higher for their own than their parents' global ratings. CONCLUSIONS: In children under 11, clinicians can gain complementary information from questioning children and parents. For children over 11, parents can provide little if any information beyond that obtained through questioning the child.