ASTHMA TIPS The American Lung Association says: Make sure your child has a medical checkup before school begins. Be aware of what triggers your child's asthma attacks, and work with the teacher to keep him or her away from them. Triggers may include exercise, smoke, pollen, dust, outdoor air pollution, animal fur, stress, colds and flu. If your child is coughing or waking up at night, it may be a sign that asthma is not under control. Work with your child's doctor to adjust the medication or make other changes. Meet with your child's doctor to come up with a written asthma action plan that you can share with your child's teachers, coaches, school principal and school nurse. The plan should include details about your child's asthma symptoms, daily medications and inhaler use, any limitations on physical activity and instructions on what to do if an asthma attack occurs. Schedule a flu shot for your child for September or early October. Flu can trigger asthma attacks, so it's important to prevent your child from catching the virus. Help school officials identify and eliminate some of the things that may be causing asthma attacks in students. -- Erin Kelly, Gannett News Service

More than six times as many asthmatic children of elementary school age are admitted to the hospital in early fall than during the hot, smoggy days of summer, according to studies done by scientists in the United States and Canada.

"Researchers speculate that it has to do with kids getting together in small indoor spaces again and passing around viruses," said Dr. Norman Edelman, chief medical officer of the American Lung Association. "Getting a respiratory virus such as the flu or a cold can trigger an asthma attack."

Indoor air pollution ranging from mold growing on ceiling tiles to fur shedding off the class hamster also can cause attacks. Even the fumes from strong cleansers used by janitors can pose a threat.

"Then there's the problem of the diesel-powered school bus sitting out front with its motor running," Edelman said.

Making matters worse, many parents send their kids back to school without giving teachers and school officials the information and medication they need to help their children prevent a potentially deadly attack.

The lung association recommends that parents sit down with their child's doctor and write up an "asthma action plan" that informs school staff about a student's asthma symptoms, daily medications, and limits on physical activity.

"We don't want children to end up having a crisis at school — especially when it can be prevented," Edelman said.

Amalie Helms of Flint, Mich., has already been in touch with the pre-school teacher and school nurse who will help care for her 4-year-old twin boys when they start school this fall. Connor and Phelan have severe asthma.

"I let their classroom teacher know that one of the things that can bring on asthmatic attacks for my guys are perfumes and hair sprays," said Helms, a 35-year-old single mother. "They can literally be allergic to their teachers."

Patricia Sardinha of Juno Beach, Fla., said her 9-year-old daughter Emily's asthma attacks have been triggered by the stress of returning to school or taking a big test. She enlists the school nurse's help.

"I bring the nurse flowers at the beginning of the school year and line up all my daughter's prescription medications on her desk and we have a meeting," Sardinha said. "She knows what to do if Emily has trouble."

But Helms said she believes some parents are reluctant to talk to school officials about their child's asthma because sufferers often are unfairly stigmatized as weaklings who can't play sports or run around at recess with the other kids.

"When kids see TV shows like Jimmy Neutron, they see the asthmatic friend portrayed as a fat, nerdy kid with an inhaler," Helms said. "Teachers and coaches need to understand that, if asthma is controlled, these kids can do anything."