Anaphylaxis is a sudden and dangerous body reaction that involves two or more organ systems. An allergy to some substance such as a certain food, insect bite, latex or medication causes the reaction. This may be something that has or has not caused any symptoms in the past. Anaphylaxis is a life-threatening medical emergency. Waiting to get to an emergency room can be fatal.

General information for parents and caregivers about asthma, the most frequently occurring chronic illness in children. See Managing Chronic Health Needs in Child Care and Schools, 2nd Edition available from the bookstore of the American Academy of Pediatrics at https://shop.aap.org or search www.healthychildren.org for more information. In PA, please send your health and safety request with your name and phone number to This email address is being protected from spambots. You need JavaScript enabled to view it..

Asthma is among the most common chronic health conditions of childhood. Untreated asthma can make it difficult to play, learn, and grow. Warning signs include coughing, shortness of breath, wheezing, and tightness in the chest. An asthma trigger is anything that causes an asthma episode. Common triggers include allergies, illness, exercise, chemicals, and smoke. Consistent care of children with asthma at home and in the child care setting is critical to their wellbeing.

Early care and education professionals should have an Asthma Action Plan for any child or staff member who has asthma. The Asthma Action Plan provides instruction from the health professional about what to do if the child has an asthma episode. The Asthma Action Plan explains the specific care the child or staff member may need. The form identifies known triggers, what medications to use, when and how to use them, and when to contact the health care provider or go to the hospital. Everyone who cares for a child with asthma or works with adults with asthma should follow the individual’s Asthma Action Plan. Reviewed and reaffirmed 6/2018.

General information for parents and caregivers about the adverse effects of indoor pollutants on children with asthma. See Managing Chronic Health Needs in Child Care and Schools, 2nd Edition available from the bookstore of the American Academy of Pediatrics at https://shop.aap.org or search www.healthychildren.org, "Role of Indoor Environmental Exposure in Childhood Asthma", for more information. In PA, please send your health and safety request with your name and phone number to This email address is being protected from spambots. You need JavaScript enabled to view it..

Kids Asthma Management Program (KAMP) of Crozer-Keystone Hospital System gives the following 8 tips to families of children with asthma:

1. Know Asthma Warning Signs: Watch a child with asthma for these signs of early onset of an asthma episode: scratchy throat, stomach hurts, nose runs, eyes very watery, feeling tired, feeling dizzy, chest feels tight, loss of appetite, starting to wheeze a little, starting to cough. They may only be signs of an ordinary cold. If they occur in a child who is known to have asthma, observe that child more closely.
2. Be Trigger Busters: A trigger is anything that causes the child’s airway to react. Common triggers are dust mites that live on skin cells in bedding and other fabric objects, cigarette smoke, furry and feathered animals, pollen, fresh cut grass, mold, strong odors, weather changes, running/exercising hard, respiratory infections, and air pollution. Avoid exposing a child to asthma triggers as much as possible.
3. Share Information about the Child’s Asthma with Teachers/Caregivers and Families: Children spend large blocks of time in group care and at home. Sharing information about a child’s symptoms and any needed health care helps coordinate care for the child in both settings.
4. Follow an Asthma Action Plan: This plan is a tool that helps caregivers/teachers and families provide the specific care that any particular child may need. The plan identifies the child’s known triggers, what medications the child should use, when and how to use them, when to contact the child’s health care provider or go to the hospital. Everyone who cares for the child with asthma should be familiar with and have a copy of that child’s Asthma Action Plan.
5. Take Prescribed Medications Correctly: Children with asthma usually have two types of medications. These are Quick Relief (or Rescue) medication and Control (Preventive) medication. Quick Relief medication stops symptoms by relaxing the muscles that circle the air tubes in the chest. Control medication reduces the airway swelling and tendency to react to triggers. Control medication makes it less likely that a flare-up will occur.
6. Use a Spacer with an Inhaler: Inhalers provide fine droplets of medication. It is hard to time taking a deep, slow breath to pull the medication into the air tubes in the chest with the direct use of the inhaler. With a mistimed quick inhalation, the droplets merge and deposit on the linings of the mouth and throat, doing little good. When a spacer device is used with an inhaler, the bigger, heavier droplets tend to fall against the sides of the spacer tube. That leaves the small droplets in the air in the tube. It is easier to have the child take two slow, deep breaths from the spacer after spraying the mist into the spacer. Spacers come with properly sized masks or mouth tubes. They take a short time to use. If used correctly, they do a better job delivering the necessary medication, better than an inhaler alone or a nebulizer. A nebulizer is a device that makes fine mist for the user to breathe over a period of 5-15 minutes. With a nebulizer, much of the medication is lost into the surrounding air. Every adult who is involved in giving inhaled medication to a child should receive direct instruction from a health care professional about how to use the asthma devices and medications correctly.
7. Have Quick Relief Medication For Every Child With Asthma: Be sure that the child’s health care professional prescribes quick relief medication to use if the child starts to have an asthma episode. All the child’s caregivers/teachers must know how to use this medication and be able to do so promptly. It is best to keep Quick Relief inhaler medication with a spacer at home and another set in the child care program.
8. Work With the Family to Know When Frequent Asthma Episodes Signal a Need for More Medical Advice: Generally, children with asthma should return for more advice from their health care provider if they need to use their Quick Relief medication more than twice a week, wake from sleep with asthma symptoms more than twice a month, refill their Quick Relief medication or need steroid medication for their asthma more than twice a year.

Adapted with permission of Zalika Shani, MPH, MCHES, Program Manager, and Dr. Vatsala Ramprasad, Pulmonologist, Kids Asthma Management Program. Crozer-Chester Hospital, Delaware County, Pennsylvania

This handout provides links to state and national organizations with rich content related to asthma on their websites or ability to offer in-person/online asthma education. In addition, there are links to many useful forms and handouts,some in both English and Spanish. Updated February 2015.  

Click here for asthma information available from this U.S. Government website. You will find information sheets and forms to help child care providers care for children with asthma as well as information about other lung diseases. These include emergency protocols, guidance for handling physical activity for children with asthma, and a checklist of environmental factors that child care providers can remove to decrease illness among children with asthma . Many of the materials are in English and Spanish. 12/2012

This workshop uses interactive discussion, visual aids and hands-on demonstrations to address the causes, symptoms, bodily responses, and current prevention and management for asthma episodes. 

This asthma website includes handy forms and links to other resources for the care of children with asthma in English and Spanish. These forms help families and early care and education providers exchange information easily when the child is having symptoms at home or in the program. Other forms on the website help health professionals to communicate their recommendations for the child's care to families and other caregivers. Reviewed and reaffirmed 3/2018.

Asthma is one of the most common chronic diseases in children. Use the recorded ECELS webinar to learn more about asthma. In this webinar you will learn about asthma symptoms, resources and tools to care for children with this special need.  Presenters for this webinar include Dr. Susan S. Aronson, MD, FAAP, ECELS Founder and Pediatric Advisor and Zalika Shani, MPH, MCHES - Program Manager, Kids Asthma Management Program, Crozer-Keystone Health System.

This webinar is designed for Child Care Program Directors and Teachers/Caregivers. Family Child Care Providers, Child Care Health Advocates, Child Care Health Consultants, Head Start Coordinators and teachers. Pennsylvania participants can receive 1.5 hours of PA Key and PA Act 48 professional development credit by completing and sending the evaluation form to ECELS. 

To listen to the recording, click here.  There is a 30 second delay before the webinar recording starts.  Download the handouts and evaluation form in the links below. 

General information about ADHD for parents and caregivers. See Managing Chronic Health Needs in Child Care and Schools, 2^nd Edition available from the bookstore of the American Academy of Pediatrics at https://shop.aap.org/ or search www.healthychildren.org for more information. In PA, please send your health and safety request with your name and phone number to This email address is being protected from spambots. You need JavaScript enabled to view it..

Is there a child in the early education program who is more active than the other children? Is this a child who doesn't seem to pay attention or follow directions? Such children are very hard to handle!

Teachers/caregivers, the child's family and the child will benefit from seeking guidance about how to care for a child with this behavior. Teachers should talk with a supervisor about a good way to share their concerns with the child's family. The family may have similar concerns and not know where to turn for help.

Behavioral problems, inattention, hyperactivity, or impulsivity are symptoms of attention-deficit/hyperactivity disorder (ADHD). The American Academy of Pediatrics publishes clinical practice guidelines. One of these specifies how to assess, diagnose and treat children as young as 4 years of age who have ADHD symptoms. The guideline says that the child's health care provider should do an assessment that includes a complete health history, vision, hearing and developmental-behavioral screening and a physical exam. The assessment may reveal one or more problems that require further evaluation.

With parent consent, the early education staff should offer to share with the child's health care provider any information the program has collected about the child. Include any developmental-behavioral screening or observations. You can use the Behavioral Data Collection Sheet, a form in the Tools tab of the ECELS website. This sharing of information can be a valuable contribution to the health professional's assessment.

The initial treatment for preschool-aged children with ADHD is evidence-based family and/or teacher-administered behavior therapy. Plan with the child's therapist and family how the program staff should handle the child's behavior. Consistent approaches at home and in the education program usually work well. The best way to do this is to have a written Care Plan.

Pediatric health professionals will be aware of local options for behavior therapy for young children. A good starting point for families and teachers/caregivers to learn about "challenging behaviors" is to go to the PA Promise for Children website, www.papromiseforchildren.com. Click on the "Help Your Child Grow" heading on the home page. Then select "Dealing with Challenging Behavior". Caring for a child's challenging behavior is difficult. However, the child will benefit when program staff, the child's family and the child's health care provider make and carry out a plan together.

Contributed by Beth DelConte, MD, FAAP - ECELS Pediatric Advisor

Reference: Center for Disease and Prevention (CDC)/Attention Deficit Hyperactivity Disorder (ADHD) http://www.cdc.gov/ncbddd/adhd/guidelines.html

Autism spectrum disorder (ASD) is a developmental disability. ASD causes social, communication and behavioral difficulties. Children with ASD can be diagnosed and start to receive services as early as 2 years of age. Children with ASD can receive free services that help minimize their disability. These services can be provided at home, in a child care center, nursery school, play group, Head Start program, early childhood special education classroom or other settings.  

Tips for parents and caregivers addressing the causes and solutions for common behavior concerns in young children. Reviewed and reaffirmed 4/2018.