Approximately 1.3 million children in the US are likely to become homeless each year. Beginning in 4/98, children with asthma in 3 homeless shelters in NYC were invited to join a multidisciplinary intervention program. The Childhood Asthma Initiative includes primary care-based asthma diagnosis and treatment (NAEPP guidelines), asthma education, psychosocial services, and environmental interventions. Preliminary results (N=102) show high rates of asthma severity among school age children with asthma assessed by an MD/PNP using a structured interview: 87% reported persistent asthma. Of children with persistent asthma, 57% reported significant rates of sleep disturbance due to asthma (2x/wk to nightly). 35% missed ³1 week of school in the past year. Even more striking, given high rates of day and nighttime symptoms and stresses of life in a homeless shelter, a remarkable 53% of children with persistent asthma didn't miss any school, yet energy levels, concentration and ability to learn may be compromised. Only 7% reported taking appropriate anti-inflammatory medication and 56% reported that 3-6 of their worst asthma months fell during the school year. In addition, 40% of their parents lost sleep ³2x/wk, often nightly, but managed to get their children to school. These findings reflect the underestimated impact of asthma on school functioning of homeless children, along with the perserverance of parents coping with the pressures of being homeless. There is critical need for coordinated support, particularly parent-school communication, asthma management programs, and attention to the quality of school experience for homeless school age children with asthma.
Learning Objectives: At the conclusion of this presentation, participants will be able to identify key issues facing school-age homeless children with asthma. Participants will be able to describe how asthma severity, sleep disturbance due to asthma, and undertreatment not only result in high rates of school absenteeism, but also impact the level of functioning necessary while these children are in school
Keywords: Asthma, Children's Health
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.