Management of food allergies and asthma in schools

Including young children in their food allergy care: A pilot study

Rationale

Food allergy education is often directed toward adult caregivers. However, once children go to school, they must participate in their food allergy care to remain safe. The purpose of this study was to assess food allergy knowledge and test an educational intervention targeted toward the child. We hypothesized that child-based teaching will be equal in safety and knowledge outcomes compared with standard parental education.

Methods

Twenty-nine children between the ages of 5-11 years and their caregivers were enrolled. Child subjects completed a food allergy knowledge questionnaire. Each caregiver/child dyad was randomized to receive parent-targeted education (control) or child-targeted education (treatment) and was given an educational booklet. Six weeks later, the child completed the same knowledge questionnaire. At the end of the semester, the caregivers were asked to report allergic reactions that occurred at school.

Results

There were no differences between the groups on age or type of school attended. All the subjects demonstrated a statistically significant increase in allergy knowledge from time 1 (completion of survey 1) to time 2 (completion of survey 2) (t = -6.301; p < 0.001) There was no difference in knowledge between the groups at time 2 (t = -1.782; p = 0.089) and no difference between the groups on allergic reactions during the study period (χ2 = 2.33; p = 0.13).

Conclusion

This pilot study, with a small sample size, demonstrated that child-based education was comparable with education targeted toward caregivers, with no difference in allergic events. Children can take an active role in education and management of their food allergies at school.

Severe Asthma and Allergy: A Pediatric Perspective

Severe asthma in children is associated with significant morbidity and lung function decline. It represents a highly heterogeneous disorder with multiple clinical phenotypes. As its management is demanding, the social and economic burden are impressive. Several co-morbidities may contribute to worsen asthma control and complicate diagnostic and therapeutic management of severe asthmatic patients. Allergen sensitization and/or allergy symptoms may predict asthma onset and severity. A better framing of "allergen sensitization" and understanding of mechanisms underlying progression of atopic march could improve the management and the long-term outcomes of pediatric severe asthma. This review focuses on the current knowledge about interactions between severe asthma and allergies.