Daytime symptoms |
In a week when your child is not having problems with his/her asthma, how often does he/she have symptoms such as coughing, wheezing or chest tightness? |
Not at all, 1 to 3 times/week |
3 to 4 per week, 5 or more, symptoms with physical activity |
Night-time symptoms |
How often in the past 2 weeks did your child wake up with asthma symptoms such as coughing, wheezing or chest tightness? |
Not at all, 1 to 3 times |
4 to 8 times, 9 to 11 times, all the time |
Activity limitation |
Is your child limited in the kind of play he/she can do because of his/her asthma? |
No |
Yes |
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Is your child limited in the amount of play because of asthma? |
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Exacerbation |
How severe is chest tightness on a typical day this past month? |
None, mild |
Moderate, marked, severe |
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How severe is wheezing on a typical day this past month? |
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How severe is shortness of breath on a typical day this past month? |
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How severe is your child’s cough episode on a typical day this past month? |
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Emergency visits |
In the past 12 months, did your child need to go to the emergency room for his/her asthma? |
No |
Yes |