Assessment of asthma control in children

After starting or adjusting asthma therapy (reliever or preventer) in a child, assess symptom control and response to therapy after 4 to 6 weeks (or earlier as required) to determine ongoing management. Asthma symptom control is defined by the frequency of symptoms over the previous 4 weeks—see Classification of asthma symptom control in children for definitions of good, partial and poor control.

If asthma is well controlled, consider stepping down therapy—see Stepping down asthma therapy in children for details.

If asthma remains only partially or poorly controlled, consider stepping up therapy—see Stepping up asthma therapy in children for details.

Table 1. Classification of asthma symptom control in children
[NB1]
Good control	Partial control	Poor control
All of the following features: daytime symptoms (eg wheezing or breathing problems) on 2 or fewer days per week, lasting a few minutes and rapidly relieved by SABA no limitation of activities; child is fully active, runs and plays without symptoms no symptoms during night or on waking, including no coughing during sleep need for SABA reliever on 2 or fewer days per week [NB2]	One or two of the following features: daytime symptoms (eg wheezing or breathing problems) on more than 2 days per week, lasting a few minutes and rapidly relieved by SABA any limitation of activities; wheeze or breathlessness during exercise, vigorous play or laughter any symptoms during night or on waking (eg waking with symptoms of wheezing or breathing problems) need for SABA reliever on more than 2 days per week [NB2]	Either of the following features: daytime symptoms (eg wheezing or breathing problems) on more than 2 days per week, lasting minutes to hours or recurring, and partially or fully relieved by SABA three or more features of partial control per week
Note: SABA = short-acting beta₂ agonist NB1: Asthma symptom control is based on symptoms over the previous 4 weeks. NB2: Not including SABA taken prophylactically before exercise; record this separately and consider when assessing management. Adapted from the Australian Asthma Handbook © 2020 National Asthma Council Australia. Accessed 31 August 2020.