To date, no validated scoring system is available to assess young children with suspected asthma who may benefit from asthma controller therapy.

As part of a larger study evaluating the utility of an asthma risk questionnaire (ARQ), clinical data for preschool children with ≥1 episode of wheeze and not on controller agents were analyzed. Children were enrolled during their pediatric office visit in the summer months. The ARQ assigns points to the following categories: asthma symptoms (56), history of acute episodes (36), family/personal atopic history (30), triggers (8). A score of >45 was chosen to indicate a potential need for controller therapy.

173 were enrolled (mean age: 31.5 ± 19.4 months; 55% male). The mean ARQ score was 40.2 ± 19.2; 40% scored >45. Those who scored >45 had the following scores: asthma symptoms 14.5 ± 12.3; history of acute episodes 14.9 ± 8.2; atopy 27.1 ± 7.8; triggers 2.3 ± 1.9. Although only 5% of parents listed wheezing as the primary reason for the office visit, many children had active asthma symptoms: 21% had >2 daytime symptoms/week; 56% had nighttime symptoms at least once a week; 20% had activity limitation. Bronchodilators were previously prescribed in 66%, but only 11% used albuterol in the previous week.

The ARQ identified a number of young children with a history of wheezing as potential candidates for controller therapy. The ARQ provides a systematic way of gathering information to assist primary care physicians in decision-making regarding the need for controller therapy in children at risk for asthma.