There is no special “asthma test” that can be used to find out if someone has asthma.  Asthma is diagnosed based mostly on the child’s history.  Usually the child has had several episodes, over a long time, of cough, wheeze, chest tightness, or shortness of breath before the diagnosis is made.  Oftentimes the child has been awakened at night due to asthma symptoms.  The child may have had symptoms when exercising or with weather changes.  These symptoms can interfere with daily activities like school and play.  The child may even had trips to the emergency room or may have received “bursts” of oral an oral steroid medicine like prednisone.

Your clinician will ask many questions about your child’s asthma symptoms:  When do the symptoms occur? How often do the symptoms occur? What you did for the symptoms? What makes the symptoms worse? What makes the symptoms better? How long do the symptoms last? Anyone in the family with asthma?  Allergies?  Any emergency room visits or hospitalizations for breathing problems?  Do symptoms interfere with normal everyday activities?  Does your child miss school due to breathing problems?  There are many more questions that can be asked.  Most of the time, based on the answers to these questions, your clinician can be pretty sure if your child does or does not have asthma.

Your clinician will then do a complete physical exam on your child.  If your child is old enough, the clinician may do peak flow meter reading or spirometry on your child.  Peak flow and spirometry are two tests of lung function.  Depending on the situation, other tests may be ordered.  Most of the time no tests are needed to make the diagnosis of asthma.  It is important to understand that no one test can tell you if your child has asthma.

Even though the diagnosis of asthma is usually made easily by an experienced clinician, there are other medical problems that can be confused for asthma.  Sometimes, several office visits over a period of time are needed, to see how symptoms are changing over time.  Sometimes asthma medicines are started before the diagnosis of asthma is made for sure.  Your child’s response to these asthma medicines (did the medicines work?) helps make the diagnosis of asthma.