Does your child .. Never Sometimes A lot Don’t know
Develop coughs that won’t go away?
Wake up at night because of difficulty breathing?
Have a hard time taking a Deep breath?
Make noisy or wheezy sounds when breathing (awake)?
Complain about a chest that feels tight or hurts after running, playing hard or doing sports?
Wake up at night coughing?
Cough after running, climbing stairs or playing sports?
Miss days of school (absent from school) because of breathing problems?
No No Yes Don’t know
Has a doctor or nurse told you that your child has asthma, reactive airways disease or wheezy bronchitis?
Has your child stayed in the hospital overnight for asthma or for trouble breathing?
Does your child take medicine or use an inhaler for asthma?