Abstract
We examined the validity of evaluating asthmatic symptoms in children under 2 years of age using a questionnaire designed for 3-year-old children. We requested the guardians (mostly mothers) of 64 children under the age of 2 years who were seen by pediatricians to complete the questionnaire. The responses were compared to the pediatrician's diagnosis based on the ''Japanese Pediatric Guideline for the Treatment and Management of Asthma 2005''. For most of the children diagnosed as having infantile asthma by their pediatrician, the guardians reported a history of wheezing. In about half of the children who were not diagnosed as having asthma, a history of wheezing was also reported by their guardians. A history of three or more episodes of dyspnea was reported by guardians in 14.3% of children diagnosed as having infantile asthma, and in none of the other children. A history of two or more episodes of dyspnea was reported in 17.9% of children diagnosed as having infantile asthma and in 2.8% not diagnosed as having infantile asthma. If a child who experienced dyspnea three times or more was defined as having ''asthma'', then the sensitivity and the specificity for the diagnosis made by a pediatrician were 14.3% and 100%, respectively. When a child with two or more episodes of dyspnea was defined as having ''asthma'', the sensitivity improved to 17.9%, and the specificity was still sufficiently high (97.2%). These findings suggest that, in children under the age of 2 years, a history of two or more episodes of dyspnea is a distinctive symptom of asthma.
