Early Childhood Asthma

Asthma is the most common chronic medical condition among children and adolescents aged 5-17, with a lifetime prevalence of 14% (National Center for Health Statistics [NCHS], 2014). In 2014, asthma accounted for 159 deaths, 633,000 emergency room visits, was the third leading cause of hospitalization in children under age 15 and accounted for 10.5 million missed school days (National Center for Health Statistics [NCHS], 2014 & CDC, 2014). In 2009 the estimated direct and indirect national cost of childhood asthma was upwards of $20 billion annually (National Heart, Lung, and Blood Institute (NHLBI). Morbidity & Mortality: 2009). The statistics within an inner-city population, specifically in New York City (NYC) are even grimmer. Lifetime
Perceptual accuracy has been defined as the concordance between subjective patient reports of symptoms or asthma severity and objective levels of lung function or severity (Fritz, Yeung, et al., 1996; Steele, Meuret, Millard & Ritz, 2012). Both asthma control and asthma severity are constructs that combine objective measures of lung function with subjective reports of asthma symptoms. The two differ in that asthma control is used as an indicator of the efficacy of treatment and demonstrate the degree to which impairment from disease and risks of future exacerbations have been minimized. By contrast, asthma severity is defined as a measure reflecting the underlying level of disease severity and is not meant to be a measure of how well or poorly controlled asthma symptoms are at a given time (NHLBI,
Additional studies looked at parental levels of perceptual accuracy in addition to child levels of perceptual accuracy (Mittal, et al., 2006; Yoos, Kitzman, McMullen, et al., 2003). In both of of these studies results demonstrated that parents and children were equally accurate in their symptom perception. More specifically, inaccuracies were more frequent when the child was having an asthma exacerbation. During an exacerbation, both studies showed children and parents tended to underestimate the severity of symptoms. By contrast, when a child was not having an exacerbation, inaccuracies in symptom perception tended to be an overestimation of asthma symptom severity as compared to lung