Lesson Two for Grades 4-6
How Can I Help?

30 Minutes

On Your Mark

Objectives

Students will be able to:

1. State that asthma can be controlled when someone with asthma avoids the things that can make his/her asthma worse.
   
2. Describe children with asthma as active, healthy people who can run, play, and go to school.
   
3. Identify the things classmates can do to help a child who has asthma such as not tease, include the child with asthma in activities, and remind the child to take his/her medicine, stay calm in case of an emergency, get help if needed.
   
4. State that children who think they or a friend might have asthma can seek help from the people they live with, the school nurse, a doctor, or teacher.

Get Set

Teacher Preparation

• Make copies of the Post-Test if not done for Lesson One
  
• Prepare What Makes Asthma Worse cards if not done for Lesson One
  
• Make copies of the Scenarios
  
• Make copies of the Crossword Puzzle
  
• Write vocabulary words from Lesson One on the board
  
• Write the following questions on the board:
  "What part of the respiratory system is affected by asthma?"
  "Describe in your own words what happens to the airways."
  "Name one thing that can make asthma worse."
  

Go

Focus the Learner

Classroom Activity: Guide children, through either small group or whole class discussion, to discover the special plans and actions that they take to deal with the hot sun. This will set the stage for learning about the plans and actions needed to protect a child from an asthma episode.

"Think about going on an all day trip to a park where there will be swimming and games outside. The weather report says it is going to be very sunny and hot. What special plan or actions will you and your friends take so that you can have a fun, safe trip?" Responses may include: food, swim suit, equipment for the games, sunscreen, hats, a shirt to cover up, extra water.

"We have to make special plans and take extra things to avoid getting thirsty or sunburned."

"Today you will learn what special plans and actions children with asthma can do to avoid or to control asthma episodes so they can be as active as children who do not have asthma. You'll also learn how we can help someone who has asthma."

Instruction

Classroom Activity: Review Lesson One. Elicit responses to the following questions and put correct response on the board and review. Use the appropriate Respiratory System and Asthma transparency and What Makes Asthma Worse cards to reinforce the correct answers.

"Yesterday, we talked about asthma. Turn to your partner and take turns answering the three questions on the board:

"What part of the respiratory system is affected by asthma?" Response: the airways in the lungs.

"Describe in your own words what happens to the airways." Response: the airways get pinched and clogged making it hard to breathe.

"Name one thing that can make asthma worse." Responses may include: cigarette smoke, dust from pillows, exercise, furry and feathered pets.

"Remember how we made special plans for the trip to the park to keep from getting too thirsty or getting a sunburn? That way we could play all day. Well, someone with asthma can make a plan to keep healthy. They can do things to avoid asthma episodes and keep themselves from getting worse if they start an episode. That way children with asthma can run, play, and go to school just like anybody else."

Classroom Activity: Write on the chalkboard the things a child can do to prevent or control asthma episodes:

a. Avoid things that make asthma worse.
b. Take medicine.
c. Use a Peak Flow Meter.

An alternative, more interactive lesson is to group children in threes. Each child in the group reads and then teaches the others in their group about one of the topics discussed below.

"Let's talk about each one of the things that a child can do to control their asthma."

a. Avoid things that make asthma worse.

"Many asthma episodes can be avoided. One of the most important ways to keep from having an asthma episode is to stay away from things that make asthma worse. For example, when Janie is around furry and feathered pets, her airways swell up and she starts to have trouble breathing. The longer she stays around the pet, the worse she feels. How could Janie prevent an asthma episode?" Response: Stay away from the pet.

"What things could she do to keep an asthma episode from getting worse if she had already handled the pet?" Response: Go into another room. Wash her hands and face. Take her asthma medicine.

Give additional examples such as staying away from other things, such as cigarette smoke and paint, as time allows.

"Exercise, running, and playing hard can make some children's asthma worse. But it's important to exercise and to stay healthy. Children with asthma often take medicine before or during exercise to avoid an asthma episode. They just have to plan ahead, just like we planned for our trip on a sunny, hot day."

b. Take medicine.

Background Note: Scientific advances have changed our understanding of asthma. We now know that asthma is not a condition with isolated episodes (attacks). It is a chronic condition that makes the airways overly sensitive. Chronic inflammation (swelling inside the airways) is the main contributor to this airway sensitivity. Treatment for people with anything more than mild, occasional episodes includes daily therapy with anti-inflammatory medicines that prevent or reduce inflammation. This helps reduce the sensitivity of the airways and prevent episodes. Doctors usually prescribe this medicine so students can take it before and after school, but sometimes it is necessary to take preventive medicine during school hours. Both medicine taken on a regular preventive basis and medicine needed to control an asthma episode should be available and convenient for the student at school. Many students can even carry and self-administer their medicine. If your students with asthma have difficulty getting their medicine, please discuss this with the parent, school nurse, and school principal. Children take medicine in different ways including pills. inhalers, syrups and nebulizers. Students should never share medicines.

"Many people take medicine to keep asthma episodes from happening. Some children may take it every day. Taking medicine every day even when they feel fine is very important because it keeps their airways from getting swollen and more sensitive. Children with asthma can keep their airways open and feeling fine by taking their asthma medication. Some children take medicine just before exercise. This medicine helps stop the muscles from squeezing the airways."

"Children take another kind of medicine after they start to have trouble breathing during an asthma episode. When an episode starts, it is very important to start taking medicine right away. This stops the problem before it gets too big. If children with asthma take their medicine right away, they usually will feel better quickly and be able to go back to their activities. If they don't take their medicine right away, the breathing problems may get so difficult that they have to stop their activities and take even more medicine. It's like putting out a fire. If a fire is small, you can put it out quickly with a little water. If you wait, the fire gets bigger and it takes lots of water, fire trucks, and lots of help to stop it. Just like our plan for our trip, children with asthma have a plan for dealing with an asthma episode."

"An asthma episode can be mild or serious. A mild episode can make someone cough or be short of breath for a little while. When the episode is serious, people may wheeze and have a lot of trouble getting enough air. Whether the episode is mild or serious, children with asthma need to follow the plan that they worked out with their doctor and family to stop their asthma episode. They may need to take medicine, see their doctor, or even go to a hospital. But, most asthma episodes can be controlled before they get serious. That's why it is so important to act right away once the first signs of an asthma episode are noticed."

c. Use a peak flow meter.

"Some people use a tool called a peak flow meter to tell them how much air they are getting in and out of their airways. Just as we use a thermometer to tell us if we have a fever and need medicine, a peak flow meter can tell people who have asthma if an asthma episode is about to happen and they need to take medicine."

Additional Activity: If there is a child in the class with asthma, s/he may volunteer to talk about his/her asthma and show his/her medicine and peak flow meter. The school nurse, a volunteer from a hospital, or a parent can be invited to come and give a demonstration of the peak flow meter comparing the readings before and after exercise for the whole class or on a few students. The person could also demonstrate asthma medicines.

Check for Understanding

"Can you name one thing people with asthma can do to control their asthma?" Avoid things that make asthma worse, take medicine, use a peak flow meter.

"How can medicine be used for asthma?" Response: some medicine is used to prevent an asthma episode. Other medicine is used to stop or reduce an episode that already has started.

Instruction

"People with asthma feel fine most of the time. They don't want to be treated differently. When they do have an asthma episode, it is important to be kind and helpful."

Classroom Activity: If you have already instructed students in problem solving, use your model/format. In the scenario, the problem can be "solved" from Joe's point of view or from that of the rest of the class. Have the students "solve" it from the class's point of view first. If time permits, you can go through the steps as if you were Joe.

Scenario:

"Joe doesn't want to take his asthma medicine before his PE class or recess because other kids tease him about it. They say mean things. One kid called him a druggie. Some kids even hide his medicine from him. Joe feels hurt, angry, and embarrassed. During the PE class, many of the kids don't want Joe to be on their team because he often ends up having an asthma episode."

Divide the class into groups of 4-5 students. Distribute one scenario (use the Scenarios sheet) to each group. Ask each group to identify a recorder, a reporter, a timekeeper, and one or two people to keep the group on the task. Have them discuss the questions and record their answers. Debrief the small group responses with the entire class. Summarize helpful and kind things students can do for someone with asthma. This may include: no teasing, no pressure to do things or stay around things that make the asthma worse, letting them take their medicine without making a big deal about it, reminding them to take their medicine before exercise when applicable, and helping during an asthma episode by getting adult help.

Select the scenarios that are most appropriate for your students. You can develop additional scenarios or encourage students to work on a problem that actually happened in your class or school. Working through the scenarios is an excellent way to reinforce a social climate which supports a child with asthma or other conditions. During your discussion, help students recognize that behavior like hiding a medicine or making someone with asthma be around something that can make his/her asthma worse can be very dangerous. It can make the student sick and perhaps lead to a very serious asthma episode.

Additional Language Arts Activity: Have students write to the child in their scenario who has asthma, giving the child suggestions of how she/he could respond to their classmates.

Additional Dramatic/Performing Arts Activity: Have students practice and perform scenarios as skits for the class. If time allows, you can make this section more active by having students write responses to the following questions on cards and show to the rest of the class.

Classroom Activity:

Question:

"We've identified ways we can be helpful to people with asthma. What signs or symptoms might make you think you might have asthma?" Responses include coughing, trouble catching my breath after exercise, coughing when I am around chalk dust.

Background Note: Most children will cough when exposed to chalk dust or may be short of breath after vigorous exercise. This does not mean that the child has asthma. A child without asthma will recover quickly, without medicines. A child with asthma may require medicine to recover.

Question:

"Now I would like you to think about what you would do if you thought you had asthma." Responses should include telling parent(s)/guardian, school nurse and/or other trusted adult.

Question:

"How can we help classmates with asthma?" Responses should include: children with asthma in all activities, do not make fun of their medicine, help them stay away from the things that make their asthma worse. If needed, remind students that they can not catch asthma from each other.

"The sooner people find out that they have asthma, the easier it will be to control and avoid serious asthma episodes and lead a life full of activities."

Finish

Closure

"Today you have learned ways that people can avoid and control asthma episodes by taking medicine, avoiding the things that make asthma worse, and using a peak flow meter. When people with asthma keep it under control, they can run, play, and go to school like everyone else. We also learned that we can help people with asthma by including them in activities, reminding them to take their medicine, and not teasing them."

Classroom Activity: Administer posttest. Review correct responses.

Additional Language Arts Activity: Use crossword puzzle.

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