Asthma is the most common chronic disease of childhood in the United States, affecting approximately 6 million children under age 18. In Broward County, year-round heat, high humidity, and persistent allergen exposure mean South Florida children face asthma challenges that are more constant and complex than those experienced by children in cooler, drier climates. At Advanced Asthma Clinic in Plantation, FL, Dr. Frank Hull has more than 20 years of experience helping children and families navigate diagnosis, school management, and the most effective treatments available today.
This guide covers what parents in the Plantation, Fort Lauderdale, Davie, Miramar, Pembroke Pines, Weston, Coral Springs, and surrounding Broward County communities need to know about childhood asthma -- from the first signs to specialist care.
Asthma is a chronic inflammatory disease of the airways. In children, the airway walls swell, the muscles surrounding the airways tighten (bronchospasm), and the airways produce excess mucus -- all of which narrow the passage through which air must travel to reach the lungs.
Most childhood asthma has an allergic (atopic) component. Children who develop eczema or allergic rhinitis early in life -- the so-called "atopic march" -- have a significantly elevated risk of developing asthma. A family history of asthma or allergies further increases that risk.
The GINA (Global Initiative for Asthma) guidelines distinguish asthma from other causes of wheeze in young children, noting that recurrent viral-triggered wheeze in children under 5 may or may not represent true asthma. This distinction has treatment implications: not every wheezing infant needs lifelong controller therapy, but those with the atopic profile and frequent episodes often do.
Children's asthma symptoms are not always the dramatic wheezing attack that most parents imagine. Many children present primarily with cough -- particularly at night or early morning, or triggered by exercise and laughter.
For children aged 5 and older, spirometry (breathing test) is the standard diagnostic tool. The physician measures lung function before and after a bronchodilator dose; a significant improvement confirms reversible airway obstruction, the hallmark of asthma.
For children under 5, spirometry is unreliable. Diagnosis rests on clinical criteria: symptom pattern, physical examination, family history, response to a trial of inhaled bronchodilator therapy, and allergen testing. Allergy skin-prick testing identifies specific triggers and guides environmental control recommendations.
One of the most common errors in childhood asthma management is prescribing the right medication in the wrong device. A child who cannot use their device correctly receives a fraction of the intended dose. Device selection depends on age, coordination, and inspiratory flow rate.
| Age Group | Recommended Device | Notes |
|---|---|---|
| 0-3 years | pMDI + valved holding chamber + face mask | Mask must seal around nose and mouth. Remove mask as soon as child can use mouthpiece (around age 3-4). Nebulizer is an alternative for infants who resist masking. |
| 4-5 years | pMDI + valved holding chamber (spacer) with mouthpiece | Child breathes through the mouthpiece while parent actuates the inhaler. One puff per breath -- do not fire multiple puffs at once into spacer. |
| 6-11 years | pMDI + spacer (preferred) or DPI if inspiratory flow is adequate | Assess DPI technique before prescribing -- many children aged 6-8 still lack the inspiratory force to disperse DPI powder effectively. |
| 12+ years | pMDI + spacer, DPI, or SMI depending on regimen and preference | Breath-actuated inhalers (BAIs) are an option for older children who struggle with MDI coordination. Always confirm technique at each visit. |
Spacers should be cleaned weekly (hand-wash in dish soap, air dry -- do not rub, as static charge aids medication delivery) and replaced every 6-12 months or if cracked. Children often outgrow their spacer mask and need a larger size -- check the fit at each visit.
For most school-age children with asthma, the school day is one of the highest-risk periods. Physical education class, allergen exposures in classrooms (mold, chalk dust, classroom pets), and missed or delayed access to their rescue inhaler all contribute to poor outcomes during school hours.
Florida Statutes Section 1002.20 grants students the right to self-carry and self-administer their prescribed rescue inhaler at school -- including during field trips and extracurricular activities -- provided the following steps are completed:
Broward County Public Schools (BCPS) follows this law. Your child's Advanced Asthma Clinic provider can complete the physician statement at any visit.
Every school-age child with asthma should have a written Asthma Action Plan (AAP) -- a one-page document (typically Green/Yellow/Red zone format) that tells teachers, coaches, and school nurses exactly what to do if your child develops symptoms. The AAP lists:
The AAP must be updated at least annually (or when medications change) and filed with the school nurse, the teacher, and the coach. Ask your Advanced Asthma Clinic provider to complete an AAP at each annual or follow-up visit -- we will gladly provide it.
Under Section 504 of the Rehabilitation Act, children with asthma that substantially limits a major life activity (breathing, exercising) are entitled to reasonable accommodations at school. Common accommodations include: seating away from windows or high-allergen areas, permission to use the rescue inhaler during class without leaving the room, access to water to rinse after ICS use, and excused absences for severe exacerbations with medical documentation.
| Trigger | South FL Relevance | Reduction Strategy |
|---|---|---|
| Dust mites | Year-round; humidity above 50% allows continuous reproduction | Allergen-proof mattress and pillow covers; wash bedding weekly in hot water (130degF); run AC to keep humidity below 50% |
| Cockroach allergen | Major indoor trigger in Broward County; present even in clean homes | Seal food in airtight containers; eliminate water sources under sinks; use bait traps; professional pest control |
| Mold | Summer rains + humidity amplify indoor/outdoor mold counts | Fix leaks promptly; run bathroom exhaust fans; clean AC drip pans; check window seals |
| Pet dander | Cats and dogs common; dander persists in carpet and upholstery for months after removal of pet | Keep pets out of bedroom; HEPA air purifier in bedroom; vacuum with HEPA filter weekly |
| Tree and weed pollen | Two distinct seasons; no winter pollen break as in northern states | Keep windows closed on high-pollen days; shower before bed; check pollen counts at airnow.gov |
| Exercise | Year-round outdoor PE; high humidity + heat raises perceived exertion | Pre-exercise rescue inhaler (2 puffs, 15-30 min before activity) if prescribed; warm-up period; written PE accommodation in 504 plan |
| Viral respiratory infections | Rhinovirus is the #1 trigger of exacerbations in school-age children | Annual flu vaccine; handwashing education; early rescue inhaler use at first sign of cold |
The GINA guidelines provide a stepwise framework for pediatric asthma treatment. Children aged 6-11 follow a 5-step ladder similar to adults; children under 6 follow a modified 4-step approach. The goal at every step is the lowest effective dose that achieves complete asthma control -- defined as no daytime symptoms more than twice per week, no nighttime waking, no activity limitation, and no rescue inhaler use more than twice per week.
| GINA Step | Preferred Controller (Ages 6-11) | Preferred Rescue |
|---|---|---|
| Step 1 (Mild, infrequent) | As-needed low-dose ICS + formoterol (preferred) OR low-dose ICS taken whenever SABA is used | As-needed low-dose ICS-formoterol or SABA |
| Step 2 (Mild, persistent) | Daily low-dose ICS; OR LTRA (montelukast) as alternative | SABA as needed |
| Step 3 (Moderate) | Low-dose ICS + LABA (e.g., Advair Diskus 100/50); OR medium-dose ICS | SABA as needed; ICS-formoterol SMART if applicable |
| Step 4 (Moderate-severe) | Medium-dose ICS + LABA; add LTRA or tiotropium if needed | SABA as needed |
| Step 5 (Severe, specialist) | High-dose ICS + LABA + phenotyping; consider biologic (dupilumab FDA-approved age 6+; omalizumab age 6+; mepolizumab age 6+) | SABA as needed; oral corticosteroids short course if needed |
A child's primary care physician or pediatrician can manage mild to moderate asthma effectively. However, specialist referral is appropriate when:
Dr. Frank Hull at Advanced Asthma Clinic accepts referrals for children 6 and older with difficult-to-control or severe asthma. For children under 6 with recurrent wheeze, early specialist evaluation can establish an accurate diagnosis and prevent years of inadequate or unnecessary treatment.
Asthma can be diagnosed in children as young as 2-3 years old, though it is most commonly diagnosed between ages 5 and 15. In very young children (under 5), spirometry is difficult to perform reliably. Physicians rely on symptom patterns, physical examination, response to bronchodilator therapy, and family history to make the diagnosis.
Approximately 50% of children with mild, non-allergic asthma experience significant improvement or apparent remission during adolescence as airway dimensions increase. However, children with allergic asthma, severe disease, or comorbid eczema and rhinitis are more likely to have persistent symptoms into adulthood. "Outgrowing" asthma does not mean the airway inflammation resolves -- it often returns in adulthood, particularly after respiratory infections, hormonal changes, or occupational exposures. Maintaining good control during childhood reduces long-term lung function decline.
Yes. Florida Statutes Section 1002.20 permits students to self-carry and self-administer their prescribed rescue inhaler at school, including field trips, provided parent and physician authorization forms are on file with the school nurse. Broward County Public Schools follows this law. Your Advanced Asthma Clinic provider can complete the required physician documentation at any visit.
Children under 5 typically cannot coordinate a pressurized metered-dose inhaler (pMDI) without help. The recommended approach is a pMDI attached to a valved holding chamber (spacer) with an age-appropriate face mask. Nebulizer therapy is an alternative for infants and toddlers who resist masking. Dry powder inhalers (DPIs) require a minimum inspiratory flow rate and are not appropriate before age 6-7.
Yes. Broward County children face year-round dust mite exposure (high humidity favors mite survival), mold spores amplified by summer rains, cockroach allergen in homes and schools, and two pollen seasons without a frost-induced break. This means South Florida children rarely experience the natural reduction in allergen exposure that children in northern climates enjoy each winter. Year-round controller therapy and environmental control are particularly important in this region.
Referral to a pulmonologist or allergist is appropriate when asthma is not controlled on ICS therapy, the child has had an ED visit or hospitalization, there is diagnostic uncertainty, significant comorbidities complicate management, or advanced therapies such as biologics or allergen immunotherapy are being considered. Advanced Asthma Clinic accepts referrals for children aged 6 and older.
Dr. Frank Hull and the Advanced Asthma Clinic team provide comprehensive pediatric asthma care for families in Plantation, Fort Lauderdale, Davie, Miramar, Pembroke Pines, Weston, Coral Springs, Hollywood, Hallandale Beach, Deerfield Beach, Boca Raton, and across Broward and Palm Beach counties.
Our approach includes full lung function testing, allergen evaluation, personalized asthma action plans, school documentation, and access to the most advanced biologic therapies available for children with severe asthma.
Call us: 954-522-7226
Address: 10059 NW 1st Court, Plantation, FL 33324
Ask about our Better Breathing Grant program for qualifying patients.
Always consult your physician before making changes to your child's asthma treatment plan.
This article is provided for educational purposes only and does not constitute medical advice. Individual asthma management decisions should be made in consultation with a qualified healthcare provider. Advanced Asthma Clinic | 10059 NW 1st Court, Plantation, FL 33324 | 954-522-7226 | advancedasthmaclinic.com