| Asthma more likely | Asthma less likely |
More than one of the typical asthma signs/symptoms: wheeze, difficulty breathing, feeling of tightness, in the chest, cough Signs/symptoms frequent Signs/symptoms worse at night and in the early morning Signs/symptoms triggered by exercise, exposure to pets, cold air, damp air, emotions, laughing Signs/symptoms occur when child doesn’t have a cold History of allergies (e.g. allergic rhinitis, atopic dermatitis, food allergies) Family history of allergies Family history of asthma Widespread wheeze heard on auscultation Signs/symptoms respond to treatment trial of reliever, with or without a preventer Lung function measured by spirometry increases in response to rapid-acting bronchodilator Lung function measured by spirometry increases in response to a treatment trial with inhaled corticosteroid (where indicated) | Symptoms only occur when child has a cold, but never between colds* Isolated cough in the absence of wheeze or difficulty breathing History of moist cough Exercise-induced dyspnoea with noisy inspiration Chest pain Dizziness, light-headedness or peripheral tingling Repeatedly normal physical examination of chest when symptomatic Focal wheeze Normal spirometry when symptomatic (children old enough to perform spirometry) No response to a trial of asthma treatment with adequate dose and correct inhaler technique Clinical features that suggest an alternative diagnosis |
Additional information
* In preschool children, wheezing that only occurs during viral respiratory infections may not be due to asthma, but this finding does not rule out asthma. Viral respiratory infection is the most common trigger for severe acute asthma exacerbations in children of all ages.