Managing Asthma in School-Aged Children During Back-to-School Season

With the return to schools, the perennial spike in childhood asthma emergencies underscores a persistent healthcare challenge: the confluence of seasonal respiratory infections and socio-environmental factors that disrupt asthma management.

These waves of asthma-related emergencies strain children and families—through symptoms and missed school—and burden clinics and EDs, reflecting deeper clinical patterns. As described in a study on back-to-school asthma surges, the prevalence of viral infections during school reopening can amplify asthma exacerbations, particularly affecting children from disadvantaged neighborhoods. Studies show that common cold viruses—especially rhinovirus—can trigger asthma attacks in children, and some have weaker type I/III interferon antiviral responses that make them more susceptible.

Managing these exacerbations demands a synchronized strategy that bridges home and school care. Consistent asthma control requires coordinated efforts between caregivers, healthcare providers, and school personnel, as outlined in school asthma management frameworks. A comprehensive written asthma action plan can significantly mitigate risks, as recommended in national guidelines.

Because viral exposures rise with school reopening and effective control depends on coordination with schools, yet not all families experience equitable health outcomes, drawing attention to socio-economic influences on disease management. Environmental and neighborhood socio-economic status plays a considerable role in asthma control. Children in lower socio-economic areas often encounter more intense asthma symptoms and limited access to care, highlighting gaps addressed in pivotal studies.

Emerging technological solutions present new avenues for care. IoT-enabled asthma management devices (e.g., connected inhaler sensors, smart peak flow meters) are increasingly used to support adherence and symptom tracking, providing real-time data and personalized prompts between visits. These tools are being used to provide real-time data and personalized prompts, with evidence for improved adherence and monitoring; effects on exacerbations are mixed. Digital tools can help families and school nurses share symptom and medication data, including language-accessible apps for underserved communities. Advances in technology now empower both patients and clinicians to take actionable steps towards improved asthma control.

Key Takeaways:

• Back-to-school season brings a predictable surge in pediatric asthma that disproportionately affects families facing socio-economic barriers.
• Effective control hinges on coordination among caregivers, clinicians, and schools with guideline-backed written action plans.
• Common cold viruses, particularly rhinovirus, drive many fall exacerbations; prevention focuses on controller adherence, vaccination where appropriate, and prompt action plan use.
• Digital tools can support adherence and monitoring across home and school settings, though evidence for reducing exacerbations remains mixed.