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Take the Childhood Asthma Control Test*

Is There More You Can Do to Help Manage Your Child's Asthma Symptoms?

This short quiz for children 4 to 11 years old will provide a score to help assess your child's treatment plan. You should share this score with your child's healthcare provider.

If your child with asthma is 12 years or older, or if you are an adult with asthma, take the ASTHMA CONTROL TESTTM*.

How to Take the Childhood Asthma Control Test

  • Let your child respond to the first four questions (1 to 4). If your child needs help reading or understanding the question, you may help, but let your child select the response. Complete the remaining 3 questions (5 to 7) on your own and without letting your child's response influence your answers. There are no right or wrong answers
  • Complete the test by clicking the "Submit" button
  • Click the "Start Over" button to clear the form
  • Share the results with your child's healthcare provider

The results of the questionnaire are not intended to diagnose a condition or disease state and do not replace the advice of a qualified healthcare professional.

Have your child complete these questions.

  1. 1. How is your asthma today?








  1. 2. How much of a problem is your asthma when you run, exercise, or play sports?








  1. 3. Do you cough because of your asthma?








  1. 4. Do you wake up during the night because of your asthma?








Please complete the following questions on your own.

  1. 5. During the last 4 weeks, how many days did your child have any daytime asthma symptoms?







  1. 6. During the last 4 weeks, how many days did your child wheeze during the day because of asthma?







  1. 7. During the last 4 weeks, how many days did your child wake up during the night because of asthma?








*ASTHMA CONTROL TEST is a trademark of QualityMetric Incorporated.
The Childhood Asthma Control Test was developed by GlaxoSmithKline.

APPROVED USES FOR VENTOLIN HFA

VENTOLIN HFA is a prescription medicine used to treat or prevent bronchospasm in people 4 years of age and older with reversible obstructive airway disease. VENTOLIN HFA is also used to prevent exercise-induced bronchospasm (EIB) in patients 4 years of age and older. It is not known if VENTOLIN HFA is safe and effective in children under 4 years of age.

IMPORTANT SAFETY INFORMATION FOR
VENTOLIN HFA

  • Do not use VENTOLIN HFA if you are allergic to albuterol sulfate or any of the ingredients in VENTOLIN HFA. If you have any questions or are not sure, you should ask your healthcare provider.
  • Tell your healthcare provider about the medicines you take and about all of your medical conditions.
  • Use VENTOLIN HFA exactly as your healthcare provider tells you to use it.
  • Do not increase your dose or take extra doses of VENTOLIN HFA without first talking to your healthcare provider.
  • Get medical help right away if VENTOLIN HFA no longer helps your symptoms (like wheezing and trouble breathing), if your symptoms get worse, or if you need to use your inhaler more often.
  • While you are using VENTOLIN HFA, use other inhaled medicines and asthma medicines only as directed by your healthcare provider.
  • VENTOLIN HFA may cause serious side effects, including:
    • worsening trouble breathing, coughing, and wheezing (paradoxical bronchospasm). If this happens, stop using VENTOLIN HFA and call your healthcare provider or get emergency help right away. This is more likely to happen with your first use of a new canister of medicine.
    • heart problems, including faster heart rate and higher blood pressure.
    • possible death in people with asthma who use too much VENTOLIN HFA.
    • allergic reactions. Call your healthcare provider right away if you have any of the following symptoms of an allergic reaction:
      • itchy skin
      • swelling beneath your skin or in your throat
      • rash
      • worsening trouble breathing
    • low potassium levels in your blood.
    • worsening of other medical problems in people who also use VENTOLIN HFA, including increases in blood sugar.
  • Common side effects of VENTOLIN HFA include:
    • your heart feels like it is pounding or racing (palpitations)
    • chest pain
    • fast heart rate
    • shakiness
    • nervousness
    • headache
    • pain
    • dizziness
    • sore throat
    • runny nose

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

This website is funded and developed by GlaxoSmithKline.
This site is intended for US residents only.
©2014 GlaxoSmithKline group of companies. All rights reserved.

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