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Comparison of parent and student responses to asthma surveys: 2 different experiences with similar results.

INTRODUCTION

When schools prepare to address the needs of students with asthma, questions arise about the ways to identify those students. Parent reports are traditionally an important source of information for identifying clinical conditions among children, but recent studies addressing a variety of health conditions have shown that parents tend to underestimate their children's physical symptoms and overestimate physical functioning (1-10) and that parent-child agreement on health reports ranges from poor to fair for symptoms related to stomach ache, cold or flu, or aching back to moderate to excellent for symptoms related to asthma or wheezy chest. (2) Parent surveys may be more costly to administer, tend to have lower response rates, and may be more likely to require language translation than student surveys. (11-13) However, little data comparing student and parent responses to the same asthma questionnaires can be found to assure schools that students' responses can be substituted for parent reports. Although some feel this may be especially true for younger children, studies have shown no significant differences in parent-child agreement between younger and older children (4,14-15) and even that agreement is higher for children under 10 years of age than for children over 13 years. Very few of these studies relate to asthma.

Two recent studies compared parent-child responses to similar asthma questions, using slightly different study designs and quite different study populations--one among young, predominantly African-American children (grades 1-4) in an urban public school setting and the other among older, predominantly white children (grades 3-12) in a suburban private school. Yet, the studies reached similar conclusions about parent-child agreement and the relationship of age differences. The 2 studies appear together here in order to provide a wider perspective for those deciding whether to question parents or children for case detection in the school setting. Refer to pages 236 and 241 for related papers.

References

(1.) Stein REK, Bauman LJ, Epstein SO, Gardner JD, Walker DK. Pilot study of a screening questionnaire for asthma. Arch Pediatr Adolesc Med. 2000; 154:447-452.

(2.) Sweeting H, West R Health at age 11: reports from schoolchildren and their parents. Arch Dis Child. 1998;78:427-434.

(3.) Weissman MM, Orvaschel H, Padian N. Children's symptom and social functioning self-reports scales: comparison of mothers' and children's reports. J Nerv Ment Dis. 1980; 168(12):736-740.

(4.) Engel NA, Rodrigue JR, Geffken GR. Parent-child agreement of ratings of anxiety in children. Psychol Rep. 1994;75:1251-1260.

(5.) Panditi S, Silverman M. Perception of exercise induced asthma by children and their parents. Arch Dis Child. 2003;88:807-811.

(6.) Halterman JS, Yoos L, Kaczorowski JM, et al. Providers underestimate symptom severity among urban children with asthma. Arch Pediatr Adolesc Med. 2002; 156:141-146.

(7.) Guyatt G, Juniper EF, Griffith LE, Feeny DH, Ferrie P. Children and adult perception of childhood asthma. Pediatrics. 1997;99(2): 165-168.

(8.) Roberts EM. Parent reports and medication use for pediatric asthma. Adolesc Med. 2003; 157:449-455.

(9.) Strums LM, van der Sluis CK, Groothoff JW, ten Duis HJ, Eisma WH. Young traffic victims' long-term health-related quality of life: child self-reports and parental reports. Arch Phys Med Rehabil. 2003;84: 431-436.

(10.) Theunissen NCM, Vogels TGC, Koopman HM, Verrips GHW, Verloove-Vanhorick SP, Wit JM. The proxy problem: child report versus parent report in health-related quality of life research. Qual Life Res. 1998; 7:387-397.

(11.) Yawn BP, Wollan P, Scanlon P, Kurland M. Are we ready for universal school-based asthma screening?: an outcomes evaluation. Arch Pediatr Adolesc Med. 2002; 156(12): 1256-1262.

(12.) Clark NM, Brown R, Joseph CL, et al. Issues in identifying asthma and estimating prevalence in an urban school population. J Clin Epidemiol. 2002;55(9):870-881.

(13.) Yawn BP, Wollan P, Scanlon PD, Kurland M. Outcome results of a school-based screening program for undertreated asthma. Ann Allergy Asthma Immunol. 2003;90(5):508-515.

(14.) Hock G, Wyij D, Brunekreef B. Self-reporting versus parental reporting of acute respiratory symptoms of children and their relation to pulmonary function and air pollution. Int J Epidemiol. 1999;28:293-299.

(15.) Angold A, Weissman MW, John K, et al. Parent and child reports of depressive symptoms in children at low and high risk of depression. J Child Psychol Psychiatry. 1987;28(6):901-915.
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Article Details
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Author:Taggart, Virginia S.; Wittich, Angelina R.; Yawn, Barbara
Publication:Journal of School Health
Geographic Code:1USA
Date:Aug 1, 2006
Words:704
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