RECORDED Tue 06 May 2025
SUMMARY KEYWORDS: Asthma, school students, health challenges, National Asthma Council, management, triggers, school absences, preventers, allergies, sleep disturbance, family education, socio-economic impact, chronic conditions, school policies, empowerment.
SPEAKERS: Megan Gilmour, Joel Ten
Megan Gilmour 00:00
This episode is proudly brought to you by the TPG Telecom Foundation dedicated to creating opportunities to improve the health, wellbeing and education of Australian communities in need.
Hi, I’m Megan Gilmour, MissingSchool Co-founder and CEO, and this is Live & Learn. This is the podcast that unearths insights at the intersection of health and education, building a powerful alliance to keep kids with complex health conditions connected to school from anywhere. The podcast is recorded on Ngunnawal land, and we acknowledge and pay respect to the traditional owners of this land and the land on which you’re listening.
Megan Gilmour 00:44
Welcome to our weekly webcast, a place to zero in on the interplay between health and education and to amplify the voices of those supporting school students to navigate their educational journeys despite complex health challenges.
And today we have with us Dr Joel Ten. Dr Joel Ten is a general practitioner with over 15 years of clinical experience in hospital and clinical settings. He has worked across multiple specialties, including emergency medicine, psychiatry, obstetrics, pediatrics, internal medicine and general practice.
A member of the National Asthma Council Australia’s GP advisory group, he is an active health educator and regular spokesperson, welcome Joel. We’re so excited to have you on Live & Learn today.
Joel Ten 01:33
Thank you so much for the very kind introduction.
Megan Gilmour 01:36
It’s our absolute pleasure, and so today we’re here to talk about supporting school connections for students with complex medical or mental health conditions. Let’s head to the first question.
Joel, tell us how asthma impacts kids and why it’s something every Australian needs to know and care about.
Joel Ten 01:58
Yes, that’s a really good question. Unfortunately, asthma actually affects quite a number of children. The statistics suggest that it’s about one in nine Australian children. So, it’s really one of the most common chronic conditions for Australian kids.
You know, when I think about asthma – my son has it himself as well – it can really affect a child’s ability to play, to learn, to sleep, and in the really severe cases, can even lead to hospitalisation or even death.
And as a parent with a child with asthma, I can certainly say that, yes, this is pretty much all of those things. When he’s got a virus, and he’s having an attack, he’s not able to sleep well at night. He was actually hospitalised once for the condition as well.
So that’s why it’s something that affects a lot of families, and it peaks during school terms. So, it’s something that, really, every Australian should be aware of, not only to manage the problem effectively, but also to support the children who are living with it as well.
Megan Gilmour 03:18
Thank you for that enlightening introduction. One in nine – that’s a lot of kids.
Joel Ten 03:24
Yes absolutely.
Megan Gilmour 03:27
So, many people probably assume things about asthma. What’s the million-dollar question that you get from parents or loved ones when their child experiences or is diagnosed with asthma? I guess you can draw on your lived experience here.
Joel Ten 03:43
Yes. Look. I mean, probably the most common question is ‘Will my child grow out of it?’ And I, personally, myself, had asthma as a child, and I also grew out of it as well.
And you know there are some kids who do see improvements as they get older, and that’s a really great thing. Asthma is a variable condition, however. So, our focus really needs to be on good management of the condition, rather than just thinking, ‘Ah, you know, he or she’s going to grow out of it one day’.
So, the short answer to that question, ‘Will my child grow out it?’ is, really, it depends. Yes, wheezing in children under five can often be transient. Sometimes it just comes only when they’ve got a bug, and then it goes away and they never have any issues out of it. But for others, asthma can persist into adolescence or adulthood itself.
So that’s why, for me, whenever I get this question ‘Will my child grow out it?’ I always tell parents, look, let’s treat them, make sure that they’re well treated. And maybe they will grow out of it in the future. But it’s one of those things where we will have to see.
Megan Gilmour 05:07
Yes, thank you. And you probably have answered my next question, which is, what’s the most important thing that you want them to know? But you may wish to add something to that, if there’s anything else sitting there.
Joel Ten 05:19
Yes, look, I really want to tell parents and people who do have asthma out there that the big thing is that asthma is manageable, okay. We can’t promise a cure or anything like that, but honestly, with the right plan, the right medications and the right supports, most kids with asthma can live very full, active lives.
But really early diagnosis and consistent follow up are really the key points. My son is just doing things as any other kid would, he’s on his preventer, he takes it regularly, and he just does everything as a normal child. He doesn’t even take anything whilst he’s at school, basically. So, you can live a really full, active life as long as we manage it properly.
Megan Gilmour 06:09
Yes, that’s a great message for people to hear out there and reassuring too, given the number of children who have asthma.
Joel Ten 06:19
Absolutely.
Megan Gilmour 06:20
So, you partially answered this one too, but I won’t make any assumptions. We’d love to know, if you’re willing to share what brought you into the world of asthma?
Joel Ten 06:34
Well, I guess I almost, in a sense, stumbled on it by accident, in the sense that I’ve been working as a GP for many years now, since 2011 and I happened to be working many years ago in a practice with an asthma nurse, and she happened to be a part of the National Asthma Council.
She said, ‘Hey, do you want to get involved? You want to help us out?’ And I thought, ‘Oh, yes, why not’. And as someone who has had asthma, myself, thankfully no longer, as I grew out of it, but I thought, it’s something that I’d like to be involved with.
And so, I kind of almost fell into it, and I just got more and more involved. And especially as I mentioned earlier, my son then developed it as well, I thought, ‘Oh well, I’m kind of in the right space in a sense, to be able to help him out, but also just really educate people.’
And, you know, as I’ve been working in community health in the past, I really saw how asthma, unfortunately, disproportionately affects families in lower socio-economic backgrounds. I’m fortunate. I’ve got a medical background, and I know how to treat asthma. But even then, you know, when you’re you know when you’re in the thick of it, it’s difficult.
Like, I still brought my son to hospital because, you know, I still wanted, you know you’re a parent, first and foremost, and then you’re a doctor, second.
Megan Gilmour 08:08
Yes
Joel Ten 08:09
No matter who you are, but still, regardless, it does disproportionately affect those in those low SES backgrounds, unfortunately, and many have ended up in emergency departments for something that, with good education and management could have been prevented.
And so that’s why I really want to be able to help educate people. Because, as they say, prevention is better than cure, and why wait until you’re at a really bad point and you need to be in hospital when we can manage you effectively in the community setting?
Megan Gilmour 08:43
Yes. I have two observations there, or one observation and a question. It’s so interesting when I asked that question of people, and more often than not, people say I just stumbled into it. And this has apparently become a passion in their life, almost, you know. So that, that element of serendipity, of finding yourself in in something that you can’t help but stay involved in.
And the second one is a question. Just wanted to know, when you say asthma affects or disproportionately affects people in lower socio-economic circumstances, so the prevalence is the same. But is it, well, I should ask, is the prevalence the same, and by affects, you mean the management is not as good in those circumstances, leading to complications?
Joel Ten 09:40
Yes, yes. So, yes, exactly, right there. So overall, you know, as I mentioned, the stats are about one in nine. But the real issue is that, I guess, unfortunately, when those who are perhaps less well educated, they don’t realise what kind of condition this is.
Some people are less likely to pay attention. You know, maybe they just think, ‘Oh, my child’s got a bit of a cough. It’s not going away – happens every time it’s winter’, but they just kind of put up with it. Or they don’t realise that there are effective treatments. They think, ‘Oh, it’s kind of their lot in life, in a sense’.
And so that’s why it’s really all about education. It’s not normal for your child to be coughing all the time, and it was not normal that they can’t really go out there and play in the playground without feeling short of breath. It’s really educating people to tell them that, yes, it is actually possible to treat this condition and to treat it well so that they can live better lives.
But it’s not only just about the short term, because some people think, ‘Oh, it’s not that bad,’ but really long-term consequences can be quite unfortunate, because chronic asthma not properly or well managed, not only can it have dire situations when they get a really bad flare up and which leads to hospitalisation, but in the long term, can also affect their lungs in a more permanent way, reducing lung capacity and leading to other conditions like COPD and so on.
So that’s why the key is to manage it well and properly, and to educate people to say that, yes, there is something that we can do for this condition.
Megan Gilmour 11:27
Yes. Thank you for clarifying that, because it was a question that I had lingering based on you talking about how important management is, and obviously, to manage you I have to first identify that this is actually what’s going on.
So that’s a great message for anyone who’s out there listening, who may suspect someone you know, a child they know, might have asthma, be able to perhaps assist in getting a diagnosis or clarity about that.
And so, knowing all that you know, what’s your biggest hope for kids with asthma, their families and loved ones when they’re navigating it?
Joel Ten 12:12
Yes, look, I mean, for me, the big thing is that I really want people to, you know, families, to really feel empowered, because it’s nothing worse than just feeling helpless and that you can’t do anything about it. So, empowerment is really key.
I just want families to be able to have that confidence, to manage asthma, to know when to act, and so that their child doesn’t miss out on life because of it.
I remember before we had kind of a really firm diagnosis with my son, there was this time when he’d just been recovering from a cold, and he still wasn’t better, and he wasn’t on the preventer yet. And it was his school athletics carnival the following day, and we brought him along, and he was trying to run the cross country, and he had to pull out at the end. He was in tears, because, you know his chest wasn’t feeling great, and you know he was upset, and that was just really sad for me.
And the following year, when he was properly, well managed, and everything was under control. He did the cross country, and he came in fifth place after that!
So, from going one year to not being able to complete the cross country to being able to come in fifth, that, to me, is just something that really goes to show that, wow, when we manage this condition, well, you know, your child can be what they want to be, in a sense.
Megan Gilmour 13:43
Yes. That’s a wonderful example to give just those two, those two polar opposite examples.
What are some of the common, perhaps frustrating, public misconceptions about asthma, and how have you seen that play a role or impact kids?
Joel Ten 14:05
Yes, yes. So, I think there are a couple of things. One big misconception is that some people think asthma is only really serious during an attack. And whilst that is true, it is serious when you have an attack, but the reality is that asthma is a condition that actually needs daily management.
Even when symptoms seem relatively mild, it’s kind of like high blood pressure or diabetes, you don’t want to wait until your blood pressure is like 200 and you’re about to have a stroke. It’s about managing it every day.
And it’s the same with asthma, just like high blood pressure over long term can lead to heart conditions, asthma, poorly managed over the long term can lead to other chronic lung conditions as well. And so that’s why I really want people to know that we need to manage asthma daily, regularly, even when it’s relatively mild, so to speak.
The other thing that I hope that parents out there know is, they’re really worried about preventers, especially when the word steroid comes into play, you know, they’re thinking, ‘Oh, preventers are really strong or maybe even unnecessary’.
And the Australian asthma handbook really clarifies that inhaled steroids are one of the most effective long-term treatments to really reduce that inflammation that’s occurring in the airways. And not only does it reduce that inflammation, it prevents flare ups.
So, that’s why those are probably the two big things [myths]: ‘We only have to treat it when they’re in the midst of an attack’, or that ‘puffers, especially sterile puffers, are really strong or unnecessary’. I hope that people can help to remove that misconception in their minds.
Megan Gilmour 16:09
Yes, and it reminds me which I should have remembered at the outset, that my father was chronic asthmatic as a child, and it wasn’t until the advent of the preventers, that in adulthood, he either doesn’t have asthma anymore, as it’s so well managed by the preventer course, you know, he’s not even on the preventers anymore, I don’t think. But it just goes to show in my own personal example and what you’re talking about there.
Joel Ten 16:46
Definitely.
Megan Gilmour 16:48
So, is there a risk of delayed diagnosis? I think there is, based on what you’ve said, or are most cases picked up easily?
Joel Ten 16:56
No, no, unfortunately, not. I mean, yes, there are some situations where it’s pretty straightforward. You know, kid comes in short of breath, they’re wheezing, you put your stethoscope, and you can hear, you know, a wheeze all over. And you’re like, okay, that’s asthma.
But then there are those kids who are not that straightforward; their only symptom is a cough, and you think, ‘Oh, is this, is this asthma, or is it just like an annoying cough?’ Because a cough, there can be multiple reasons for a cough. Maybe they’ve got a bug, maybe they’ve got a little bit of postnasal drip, like some mucus dripping down the back, or maybe it is actually airways inflammation leading to a cough.
And so that’s why it’s really important that we actually think about what is the reason for this particular symptom? So hopefully, parents and those who are, who are listening, don’t just think, ‘Oh, shortness of breath or wheeze, that is what asthma is’.
It could be something as benign as a lingering cough, you know, that sort of thing. So, I guess it’s about thinking outside the box a little bit – ‘Oh, why is my child experiencing these sorts of symptoms?’ and, you know, the trick is really to go and see your doctor.
Megan Gilmour 18:21
Yes, thank you. And what kind of complications are associated with asthma, or do kids with asthma face?
Joel Ten 18:34
Yes, I mean, there’s, there’s quite a few things. So, you know, poorly controlled asthma can lead to a number of conditions, like, for example, one is sleep disturbance, because unfortunately, especially as we’re getting into the period where the nights are getting cooler, for some people, some individuals, one of their triggers for asthma is actually cold air, okay.
So, as the weather cools down, and you know, as the night gets cooler, they can actually start coughing at night. And so that can then lead to sleep problems. And as most of us are probably aware if your child doesn’t have good sleep, they’re going to be cranky in the mornings and so on, and it does affect their learning as well throughout the day.
You know, poorly controlled asthma, can also lead to school absences. Actually, one of the leading causes of school absenteeism is asthma, actually.
And as I shared earlier with my son, not being able to run the cross country, asthma can also lead to limited physical activity, because they just struggle to breathe when they’re active.
For some children, their trigger is actually exercise, and so the moment that they start running and playing, that’s when they start to get tight in their chest, they start coughing, spluttering, being short of breath. And so those sorts of things can also – like it’s a potential complication, if you will.
And obviously there could be, in the worst-case scenario, a trip to the emergency department as well.
The long-term complication, if we’re talking about over years of not managing it, can lead to problems with the lungs and chronic conditions if not managed properly.
Megan Gilmour 20:33
Yes, and we don’t want that. We definitely don’t want that. What about allergies? Are there allergies often associated with asthma?
Joel Ten 20:38
Yes, so that’s a really good question. So, things like hay fever, eczema and asthma, they’re actually, technically all part of the same basket of immune responses called ‘atopy’, actually. And so that’s why, asthma is quite commonly associated with hay fever, you know, grass pollen allergies and so on, as well, and eczema to a degree. So, yes, absolutely, they are related in that sense, particularly your grass and pollen allergies.
Several years ago, we had that episode of thunderstorm asthma, where people who had both hay fever and asthma were really severely affected, and there was a huge spate of people who didn’t even know they had asthma, but because of those conditions where the pollen kind of swelled up with the rain and then burst into very, very small particles, it was easier to inhale into the lungs, and that resulted in what we know, now as thunderstorm Asthma.
So, in that sense, yes, allergies can definitely affect asthmatics, not always, but it can be.
Megan Gilmour 21:52
It could be part of the picture, yes. I know that during the bush fires, that was another big factor too. So those are environmental triggers for children or anyone with asthma.
So, let’s talk about siblings and peers of kids with asthma. How are they impacted? Do you hear any stories about this, or what should families be across with that?
Joel Ten 22:26
Yes, look, I mean, it’s interesting, because there’s always a little bit of an interesting family dynamic when one particular child has a chronic health condition, and the others are fairly healthy.
You know, siblings can feel a little bit anxious, especially when these sorts of things occur; if their brother or sister has a flare up, or even require a trip to the emergency department, they can get a little bit worried and anxious.
Sometimes they can even feel a little bit left out. Ironically, it’s one of those things where they kind of feel like, all the parents’ attention is on that particular child whilst they’re having a flare up.
And, you know, that’s when sometimes there can be a little bit of a dynamic where parents need to just kind of sit down and explain what is happening to the other child, so that they understand.
So, educating the whole family is really quite important, especially even the siblings. You know, we, as doctors, we generally just speak to the parents, because you should, the sibling is not there. But when parents go home, it’s also worthwhile for parents to just say, ‘Hey, look, your brother or your sister has asthma, and this is why they need to take these medications. And sometimes there are times when you know they’re sick, we might need to pay a bit more attention to them.’
Just explaining to them, because children are naturally inquisitive people, and they like to know what’s going on, and it can certainly allay a lot of their concerns, whereas when they’re kept in the dark, that’s when all sorts of things can play up in their little mind. So, it’s important to just educate all the children about what’s kind of happening and just involving them is something that’s really helpful.
Megan Gilmour 24:18
Yes, thanks for that advice. That’s something that also comes up on these calls. It’s very interesting that the observed sibling experience is quite similar across conditions, including guilt and a whole range of other things. I also imagine that there might be more than one child in the household with asthma as well.
Joel Ten 24:42
Yes, yes. I mean, it can be, sometimes that is the case because, unfortunately, it can be, in a sense, passed down. So, what we notice is that if a child has asthma, which you should ask mum and dad, do you have either of those three conditions – hay fever, eczema, asthma.
If you have one of those, because they’re kind of all in the same basket, you’re more likely to pass it down. And usually there is some sort of family history. It’s actually pretty rare, that this is the first child that has any of those three things, and mum and dad didn’t have any of them.
So, it certainly can be, in a sense, passed along, but it’s not always universal, like saying in my own family, you know, I’ve got two kids, my daughter doesn’t have asthma, but she’s got eczema, but my son, he had a bit of eczema, but now it’s mainly just asthma. So, those things can sort of pass along, in a sense.
Megan Gilmour 25:48
This is a little off script, but since we’re talking about families, can asthma be expensive for families to manage?
Joel Ten 25:58
Yes, look, unfortunately it can be. You know, those doctor visits can certainly build up and it gets even more so if you require specialist management. By far and large, most GPs can manage asthma, but there are certain ones that, where it’s quite a complicated situation, or they’re on maximal therapy and they need pediatrician input and so on. That’s where fees can start to build up as well.
I mean, overall, we’re quite fortunate in that we do have the pharmaceutical benefit scheme, the PBS, which does subsidise a number of medications. But there are certain times when even those things can build up.
And whilst I was working in the community health center, I did have patients coming to tell me, you know, ‘Look, I haven’t, you know, gotten paid for this week. Can I pick up my medications next week?’
And it’s always really difficult and sad really, when you come across those situations where people are limited by the funds that they have.
So even though we do have a lot of subsidies from the government. But even with those subsidies, you know, with the cost-of-living crisis and so on, it still can put a stretch on family budgets as well.
Megan Gilmour 27:23
Yes, and then, if we reflect back on how that might be playing into people in low socio-economic situations as well, even if they do realise what it is, they may not have the means to address it.
Joel Ten 27:38
Yes, absolutely.
Megan Gilmour 27:40
What’s the current population of school aged children with asthma. And how accurate is that data, if we have it? Is it tracked, for example?
Joel Ten 27:54
Yes. So, with the data from the ABS – Australian Bureau of Statistics and Australian Institute of Health and Welfare, it does suggest that one in nine or about 11% of school age kids have asthma.
It’s pretty good national data, I mean, we’re talking about all of Australia, but I guess the reality is not all schools, and places consistently track or manage this, and especially when it comes to other things that are pretty good indicators that someone is well managed, like having an asthma action plan, for example.
I mean, there could be a lot of families out there who are aware that their child has asthma but have quite an out-of-date asthma action plan.
So, I guess it’s about tracking and making sure that kids do have an asthma action plan. And to be fair, I do get quite a few parents coming in around the start of the year to say, ‘Oh, look, you know, can I have an updated asthma action plan’.
But I guess the reality is that not every school is going to, necessarily, not to say, enforce, but, you know, encourage the parents to really just make sure that it is updated regularly, at least yearly, really.
Megan Gilmour 29:24
Yes, so on the current school population of 4 million children, students, it’s about 444,500 kids, and they’re the ones with diagnosis, right? Because one in nine is diagnosed. So given what you’ve said, we could be looking at a higher population than that.
Joel Ten 29:46
Definitely.
Megan Gilmour 29:48
And given what you’ve said about disrupted sleep, and some recurring symptomology and things like that, and fatigue and it’s worth considering the impact that this really does have – in school and out of school.
Joel Ten 30:08
Oh, yes, absolutely.
Megan Gilmour 30:10
And this speaks to the next question, which you kindly answered earlier on, do kids with asthma currently miss a lot of school, and why?
Joel Ten 30:20
So definitely, as I mentioned, it is one of the leading causes of school absenteeism. And it really spikes up during the colder months, you know when viral infections are circulating. And the reason is basically because in quite a number of people, one of their triggers is a viral infection.
So basically, when it’s cold people are indoors more, you’re going to be spreading more germs. So, you’re not only going to be missing school because you got a virus, you got a cold, but also because of the asthma, and it takes him longer to get to get better, because of those additional effects of inflammation on the lungs as well.
So, yes, maintaining good control is really important, because then you can kind of mitigate the impact. I mean, we can’t stop people from getting colds, but we can at least either stop them or dramatically reduce the impact of the asthma from the cold.
Megan Gilmour 31:24
Yes, that’s great to know. And what have you observed as the critical times in the school life of a kid with asthma? Are there any, is there anything that stands out there for you?
Joel Ten 31:36
Yes, I mean, I think that the start of the school year is pretty important, because they actually have observed this so called ‘back to school asthma spike’ because you’ve been at home over the summer holidays and so on, and you’re not with a lot of germy kids in the sense. And then all of a sudden you put 20-30, kids into one room and that’s where all these exposures,
Megan Gilmour 32:06
A petri dish [laughter]
Joel Ten 32:07
Yes, that’s exactly right! And sadly, it’s also quite common for some parents to maybe get a little bit relaxed over the school holidays with medication and things like that, because they think, ‘Oh, it’s summer, weather’s warm, they haven’t required anything’ and they kind of drop off on the medication.
So, it’s kind of all of these things together, the return to school, all the germs, and then maybe gotten a bit relaxed over the school holidays with medications, and then, yes, just all spikes up. And that’s why rates really can come up. Yes, so that’s something that we have noticed over the years.
Megan Gilmour 32:50
Yes, that’s interesting, the ‘Back to School’ is one that comes up a lot in these conversations with other chronic conditions as well. Is there any evidence for anxiety causing the flare?
Joel Ten 33:05
Yes, look, I mean, I guess thankfully, yes, the anxiety and mental health does have a bit of a role, because stress can be a potential trigger for asthma. But usually, if it’s fairly well managed, yes, they can be back to school nerves, but as long as the asthma itself is overall well managed, I think for most people, it doesn’t really cause that much of an issue.
Megan Gilmour 33:31
Yes, and what about the puberty years, adolescence? Is there anything remarkable about that period?
Joel Ten 33:42
Yes, look, I think it’s one thing that I find that, a lot of adolescents go through, is they just want to fit in, you know, and having a puffer and carrying it around, especially because –
Megan Gilmour 33:57
A bit uncool
Joel Ten 33:58
Yes, that’s exactly right, yes, because they’re more independent. So, like for my son, we’re making sure he’s taking his medications every day. But when you’re older, a lot of parents, and rightly so, can, kind of say, ‘Hey, look, here’s your puffer. You know what to do, make sure you take it.’
But then, especially if they have exercise induced asthma, they really should be having a couple of puffs of ventilator and maybe five to 10 minutes before they do PE or anything like that.
And some kids don’t want to be seen as requiring the use of this inhaler, even though it gives them great success in being able to complete their physical activity. Sometimes because they don’t want to be seen as, ‘uncool,’ or requiring these things, then they stop using their medication. So, those are things that I guess we really just have to educate kids on and say, ‘Look, it’s okay to use.’
To be fair, though, that’s with a lot of chronic conditions, diabetes and so on, I’ve seen similar things as well, where people just don’t want to give themselves insulin because they don’t want to have to go the toilet and hide and give it to themselves. So, it’s a well recognised issue unfortunately.
Megan Gilmour 35:26
Yes, don’t stand out. Even more so at school, isn’t it?
Joel Ten 35:31
Yes
Megan Gilmour 35:32
Really, yes. So, we should mark that up for anyone listening, including teachers, that is, to have that awareness around kid’s noncompliance, perhaps, you know, especially the teenage years.
Joel Ten 35:48
And I think just normalising that there are people who have medical conditions, and that’s okay, just normalising that it’s all right for people to take medications if they need to, because the more I guess “normal“ it is, in inverted commas, then people just don’t pay attention to it ‘Oh, they use the puffer and let’s continue on,’ you know.
Megan Gilmour 36:15
Well, given the statistics around chronic conditions, there’s going to be quite a substantial number of children in school environments who are dealing with and are medicated for chronic conditions. It’s an interesting point, because we see education on chronic conditions happening in schools, and different groups do that education.
Yes, I wonder if there’s any general education, just about, you know, part of being human involves illness. Sometimes those illnesses are lifelong. Sometimes they’re for a long time. Sometimes they flare up. And you know that this is just a part of life actually.
I don’t recall hearing that there is any of that kind of education that goes on.
Joel Ten 37:10
Yes, yes.
Megan Gilmour 37:11
We have sex ed in schools and other things but maybe not ‘this what it is to be a human’.
Joel Ten 37:19
Yes, yes, that’s it. I mean, I can’t remember anything myself, but this is where I just do it in my personal parenting to my own children. Because kids, as I said, are inquisitive, and sometimes they’ll say, ‘Oh, why is that person in a wheelchair?’
And then I just have to explain, that there are people who have diseases and or conditions where they might require the use of a wheelchair or crutch or medications.
I just explain to them, and I just talk in a very normal tone of voice that there are people who are like that and who have certain conditions, and it’s just the way it is. So that way they just feel that ‘Okay, that’s what it is’.
Megan Gilmour 38:06
It’s part of life.
Joel Ten 38:07
Yes, it is absolutely a part of life,
Megan Gilmour 38:10
Yes. And I guess it’s a good point for diversity, actually, isn’t it? Is that, as part of understanding diversity and engaging oneself with the diversity of humanity, that this is definitely a part of the picture, even if it’s an invisible illness, and we can’t see the kinds of effects that it can have on people. I mean, even carrying the knowledge of it as a child or an adult, even without flares or other kind of symptomology, can be quite substantial in itself, psychologically.
And do you see children with asthma typically getting anxious, or it’s not, not big in the picture of asthma, what do you see?
Joel Ten 39:03
You know, in terms of anxieties and things like that, I mean, I feel like the more the child is aware, especially of their flares, they can become avoidant of them. And sometimes it is a good type of avoidance, but sometimes they get to the point where they’re just very anxious and always thinking about it.
And I think this is where we don’t want it to get to that stage where they’re always constantly worrying and thinking about their triggers and so on, because, like I said, we want them to be able to live their lives as normally as they possibly can, in a sense, where the disease has a minimal impact on them.
So, I think there’s this balance where we need to say, look, we recognise these may be your triggers, and it is good to avoid them, but we just don’t need to, always have it on the back of our mind.
So, I think again, it’s all about that education and making sure that they are well controlled, because if it doesn’t affect them so severely, they’re less likely to always be thinking about it all the time.
Megan Gilmour 40:15
Yes, to have that health anxiety. Yes, that’s a really good point. So, we’ve talked about the challenges and vulnerabilities at school and the condition itself and symptoms and side effects.
As we get to the end of our conversation, what do you think is happening now to address these challenges and vulnerabilities that asthma presents in school? And is it enough? Or what would you like to see if, if there was an ideal situation?
Joel Ten 40:50
Yes, I mean, there are organisations like the National Asthma Council of Australia who provide great resources, including like school kids and training and so on. But I guess uptake can be a little bit patchy. And as I mentioned, sometimes enforcement of certain policies, like asthma policies at school, is not always consistent across the board, like I do have, like I said, those parents coming in and getting their asthma action plan updated. But it’s not always going to be 100% across the board.
So I think having just that really consistent guidance, because the reality is that life gets busy, right and I totally understand that as a parent myself, I work, and there’re lots of things to do, and sometimes just, if your child is well, bringing them to see the doctor to get their asthma action plan updated is kind of like, really on the back burner, and I get it. But you know it is important, especially when we are human, and we’re prone to forget that there are all these other things in place.
And so that’s why I see the school is just another way of saying, ‘Hey, your child’s got asthma, we just realised, we noticed this. Could you get an updated asthma action plan?’ It’s just another point where, it just raises the parent, ‘Oh yes, we haven’t reviewed my son or my daughter’s asthma for a whole year now. Like, maybe it’s time to go see the doctor,’ and it just initiates that conversation as well.
So, I think this is where, obviously, if you can have the space and time to be more proactive, that would be great. But we realise that life can get busy, and so that’s why I think, yes, getting the schools on board is really helpful.
Megan Gilmour 42:50
Yes, indeed. And given everything else that you’ve said, this is a part of good management, particularly in an environment where there can be more triggers, and having that sitting in the health plan in the school, but also an Individual Learning Plan, if needed, especially if there is recurring absences across the whole school life, which can add up to a lot of missed time.
And the research says that there’s no safe threshold for absence, anything more than 10% which is, I think 20 days a year is going to put children in a challenging place, academically and then emotionally as well.
So, I think when we add all of these things together, what Joel’s saying is so important, there’s that consistency to have that plan in place in the school as well.
And that will then give the signals also around the Disability Standards for Education, which, as a national regulation that covers all schools, means that the right supports can be put in place if additional teaching and learning support is needed due to absences or even just experiencing the school or adjustments that might make it better.
For example, with sport, if a student couldn’t participate in a sporting event, well, we don’t want them just sitting there left out. We want some other ways to be inclusive, and that’s what this, having the up-to-date plan and the Disability Standards can enable and signal to a school to do. And of course, that is all funding from government that goes down to support those adjustments through the Disability Standard.
So, as we close out, is there anything else that you would like to say about quality of school life for asthma?
Joel Ten 44:58
Yes, look, just, I guess rounding up, I just really hope that all those who are listening, especially the parents know that the key message for me is that I really want you to be empowered to make those decisions on behalf of your child.
Because they [GPs] may not necessarily know what’s going on, and if you even suspect, you know if the question is in your mind ‘Could my child have asthma?’ go and see your doctor, raise that question to them, so that they can think about it as well.
Because sometimes GPs can have a lot of things that we’re thinking of. We’re seeing all these things, you know ‘Maybe your child is not up to date with the vaccinations’, and we’re also thinking about lots of other things too, about the health of your child.
But if you have that question, just ask, ‘Do you think that this cough is asthma?’ and just put it to the GP. And I just really want to empower all the parents out there, if you’re thinking about it, talk to your GP and just ask the question, and then that way you can kick start that process to a) diagnosing it, and if it is indeed asthma, then treating it and managing it properly.
Megan Gilmour 46:18
Yes. Thank you. Our call to action as we end is usually to ask, what’s your call to action for asthma in seven words or less? And I think you might have just said it, that is, if you’re thinking about it ask the question.
Joel Ten 46:31
Yes, yes.
Megan Gilmour 46:32
If you’d like to give a call to action with a different set of seven words or less go for it!
Joel Ten 46:43
Seven words! Okay, yes. I guess, my hope. I guess in seven words or less is that to empower every family to manage asthma confidently.
Megan Gilmour 46:53
Oh, that’s beautiful. That’s such a perfect ending. It’s been so wonderful to talk to you today. A big shout out to National Asthma Council, Australia. You can find them at nationalasthma.org.au [https://www.nationalasthma.org.au] is that correct Joel?
Joel Ten 47:13
Yes
Megan Gilmour 47:14
And from us to you, thank you for joining us today Dr. Joel Ten. It’s been amazing to have your insights, and your medical experience and knowledge brought to bear here, and your lived experience as well.
Joel Ten 47:30
Thank you.
Megan Gilmour 47:34
Thanks everyone for tuning in. Help us turn up the volume so all kids are seen and heard. Follow along, LIKE, SHARE COMMENT or leave us a review, because we love hearing from you. And if you want to donate head to missing school.org.au [https://missingschool.org.au] because every dollar makes a difference.
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