Date Presented 04/22/2023

Pediatric OT practitioners report that asthma inhibits occupational participation. Despite moderately low asthma knowledge and perceived self-efficacy in asthma care, assessing and modifying the environment is perceived to be within the scope of OT.

Primary Author and Speaker: Lindsay A. Spell

Contributing Authors: Madelyn Yoo, Timira Minor, Kelly Harris

PURPOSE: Asthma inhibits quality of life. Reducing environmental triggers reduces asthma symptoms. Occupational therapy (OT) practitioners are trained to assess and modify physical environments, a cost-effective intervention that may improve outcomes for youth with asthma. This study examines practitioners’ perceptions on 1) their role to support youth with asthma in clinical practice, 2) feasibility and acceptability of an OT home assessment and 3) the impact of asthma on occupational participation.

DESIGN: A cross-sectional exploratory survey study.

METHOD: An electronic survey was conducted. Data was analyzed using descriptive statistics and analysis of variance.

RESULTS: Of 171 participants, most practiced over 10 years (n=125, 73.1%), work in urban (n=64, 37.4%) and suburban areas (n=100, 58.5%), and in school-based (n=82, 48.0%), outpatient (n=59, 34.5%), and early intervention (n=58, 33.9%) settings. Most had asthma knowledge scores of 7 (n=44, 25.9%) or 8 (n=56, 32.7%) on a scale of 11 and reported serving clients with asthma (n=136, 79.5%). Asthma knowledge was associated with percentage of youth with asthma on clinical caseloads (>25%, p > 0.001; >10 %, p>0.01). Participants reported low self-efficacy for trigger reduction assessment and intervention (n=52, 30.4%), yet found it to be within the scope of OT (n=163, 95.3%) and believed an assessment (n=114, 66.7%) and intervention guide (n=152, 88.9%) would be useful. Observed and reported occupational impact was highest for play (n=56, 32.7%; n=51, 29.8%), social participation (n=33, 19.3%; n=35, 20.5%) and rest and sleep (n=39, 22.8%; n=27, 15.8%).

CONCLUSION: Pediatric practitioners believe it is within the scope of OT to assess and modify the physical environment to support youth with asthma, despite moderately-low asthma knowledge and perceived self-efficacy in asthma care. An OT asthma environmental assessment and intervention guide are perceived to be feasible and acceptable for clinical practice.


Jezioro, J. R., Gutman, S. A., Lovinsky-Desir, S., Rauh, V., Perera, F. P., & Miller, R. L. (2021). A comparison of activity participation between children with and without asthma. The Open Journal of Occupational Therapy, 9(3), 1–17.

Chen, Y.-C., Tsai, C.-H., & Lee, Y. L. (2011). Early-life indoor environmental exposures increase the risk of childhood asthma. International Journal of Hygiene and Environmental Health, 215(1), 19–25. https://doi:10.1016/j.ijheh.2011.07.004

Campbell, J. D., Brooks, M., Hosokawa, P., Robinson, J., Song, L., & Krieger, J. (2015). Community health worker home visits for Medicaid-enrolled children with asthma: Effects on asthma outcomes and costs. American Journal of Public Health, 105(11), 23662372.