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CHILDREN WITH INTRACTABLE ASTHMA?╟÷STEEN asthmatic bronchitis associated with bronchiectasis and paranasal sinusitis. It points out that every year there are more people arriving in areas of Arizona and New Mexico1, and further points out that it is essential to determine whether this new climate will indeed effect an improvement so that these people may go into these new communities without becoming a ward of local charity. It is especially important to recognize if the patient will not benefit from a change of climate. Sherman and Kessler17 feel that the greatest benefit to be expected from change of climate is in severe infective asthma associated with chronic upper respiratory infection, particularly hyperplastic sinusitis, and that children who have done poorly in cold wet climates are more often improved by attending school in the West or Southwest for a year or two so that on their return they are sufficiently improved in general health to tolerate their home climate. NATIONAL FOUNDATION FOR ASTHMATIC CHILDREN Formation Several years ago the management of one of the private schools near Tucson, which provided a place for children with asthma, began to think in terms of a Foundation. In the course of time a plan was evolved to provide a place where asthmatic children from families o>f low income could be sent for treatment. In 1954 the National Foundation for Asthmatic Children started its program for the rehabilitation of asthmatic children at the Sahuaro School near Tucson. The School was to provide a program for the rehabilitation of children with intractable asthma. It would combine all known means and methods of treatment in a setting with a home atmosphere in group living. Intractable asthma is defined as perennial asthma which does not respond to the conventional forms of treatment in the child's home community and also asthma which needs steroids for its control. Only children meeting these requirements are accepted. Principal Features Which Distinguish the School Climate.?╟÷'Climate, in the past and at the present time, is one of the important phases in the treatment of the asthmatic child in the Southwest. Factors which are essential to an ideal climate are found in Tucson: 1. Outdoors as much as possible 2. Abundant sunshine 3. Great warmth 4. Little precipitation 5. Low humidity 6. Comparatively stable barometric pressure 7. Slight storminess 8. Gradual seasonal changes Volume 17, November-December, 1959 867 CHILDREN WITH INTRACTABLE ASTHMA?╟÷STEEN Tucson presents a climate with maximum amount of sunshine and minimum relative humidity, very little rain and very little wind. Normally, the barometric pressure is stable. The pollen count is low. The winters present many warm, sunny days. Although the temperature appears high in the summer, the relative humidity is low, the evaporation factor is high, and there is enough range in temperature to afford comfortable nights. Education.?╟÷The Sahuaro School is the only school of its kind which provides educational facilities on its grounds for the first eight grades. We feel that it is much better to provide education for these children at the school. It enables us to keep the children together and spares them the problem of competing with well children in the public school system. We want as much as possible to make them forget that they have asthma and we do not want them to be brought in contact with well children at this time. We would like to have them become well and happy in their way and become strong enough to meet the competition of the world later on. Individualized Medical Treatment.'?╟÷The program for medical care is individualized to the child's particular needs. Internists, allergists, pediatricians, psychiatrists, psychologists, dentists, and social workers are provided for the care of the child. A group of consultants in other specialties provide additional care as the need arises. Each child is carefully examined. The plan of treatment is carefully worked out to meet the individual needs of each child. Some children may need little, if any, treatment?╟÷they go to school, live in the cottages and receive medical attention such as normal children receive as the occasion arises. Other children have to have a more extensive program?╟÷many need specific injection therapy following skin testing, various sorts of symptomatic medicine, and others have to be treated with steroids from time to time. Still others may need psychiatric and psychological guidance. Change of Environment.?╟÷Change of environment has always been an important part of treatment throughout the years. There are many factors in change of environment other than taking the child away from his home and putting him in a new area. Removal of the child from home changes many conditions found in the house or in the territory about the home. The removal from one school to the school in Arizona results in leaving many factors and probably finding new ones. The climate of course, strictly speaking, would have to be considered under environment. Seasons, temperature changes, geographic location and atmospheric changes, all play a part in the problem. It is not wise to consider that the only advantage in changing environment is parentectomy. If nothing more, seeing a different world through the same pair of eyes is very important. 868 Annals of Allergy