Asthma Control Test – Children Asthma Control Test – Children Questions for ChildWhat is your name? What is your date of birth? MM slash DD slash YYYY How is your asthma today?0 – Very bad1 – Bad2 – Good3 – Very goodHow much of a problem is your asthma when you run, exercise or play sports?0 – It's a big problem, I can't do what I want to do1 – It's a problem and I don't like it2 – It's a little problem but it's okay3 – It's not a problemDo you cough because of your asthma?0 – Yes, all of the time1 – Yes, most of the time2 – Yes, some of the time3 – No, none of the timeDo you wake up during the night because of your asthma?0 – Yes all of the time1 – Yes, most of the time2 – Yes, some of the time3 – No, none of the timeQuestions for Parents/GuardiansDuring the last 4 weeks, how many days did your child have any daytime asthma symptoms?0 – Everyday1 – 19-24 days2 – 11-18 days3 – 4-10 days4 – 1-3 days5 – Not at allDuring the last 4 weeks, how many days did your child wheeze during the day because of asthma?0 – Everyday1 – 19-24 days2 – 11-18 days3 – 4-10 days4 – 1-3 days5 – Not at allDuring the last 4 weeks, how many days did your child wake up during the night because of asthma?0 – Everyday1 – 19-24 days2 – 11-18 days3 – 4-10 days4 – 1-3 days5 – Not at all
