Social and Emotional Support at School: A Qualitative Exploration of the Perspectives of Children Living with Asthma

This study explored the perceptions of children living with asthma regarding their school experiences, focusing on the social and emotional impact, management of asthma at school, and sources of support at school. This qualitative exploration of children’s perceptions included a sample of 19 children (8-12 years old) with asthma and their mothers. Data were collected through semi-structured interviews with the children, child drawings based on the Child Drawing: Hospital task (Clatworthy, et al., 1999), and a parent questionnaire to obtain demographic, asthma, and school data. Transcribed interviews were analyzed using thematic analysis, and drawing and parent questionnaire data supplemented the interview findings. The themes from the interviews were presented across five categories: 1) Living with Asthma [There’s Nothing Good, It Could Be Worse, “When I have asthma…”] 2) Having Asthma at School [It Gets in the Way, “I Can’t…” ] 3) Social Impact [Peer Support, “People treat me the same,” Negative Consequences] 4) Emotional Impact [Worries, Vigilance, Coping Strategies], and 5) Sources of Support [Gatekeepers, Helpful Adults, Comparing Child and Parent Sources of School-based Support, Shift Toward Self-Reliance]. Across the themes, child participants described unique experiences and conceptualizations of their asthma and its management. All children expressed some asthma-related limitations at school, mostly during physical activity, and all had engaged in asthma management at school, most with medication in addition to other strategies. Children downplayed their asthma and expressed wanting to be seen as normal compared to their peers. Many children also endorsed feeling supported by their peers. Adult support in school was mostly surrounding access to medication, to which few children had immediate access. Children with asthma viewed teachers more favorably when the teacher was reliable, understanding, and knowledgeable of asthma. Parents and children differed in their communication with teachers, and parents seemed to be responsible for establishing a relationship with the school nurse. For future practice, schools should assess their asthma medication practices and promote teacher knowledge and understanding of asthma symptoms and management. Building parent-teacher communication and relationships can also improve teacher support of their students with asthma.Doctor of Philosoph