Impact of Allergic Rhinitis in School Going Children, Capstone Project Example

Abstract   

Allergies are a common occurrence in school age children. The topic of allergies and their impact on school performance has been and remains highly relevant and timely because the number of children who suffer from allergies continues to grow in response to increased environmental pollutants, allergens, and irritants that plague the air and the environment as a whole. A survey instrument was developed to enable faculty and parents to provide insight regarding allergies and their influence on academic performance in school age children.  The survey sought to recognize how children are affected by allergies, including their level of focus and concentration on their studies. It was determined that allergies have an impact on student performance, particularly in the areas of concentration and focus. However, additional studies are required in order to ensure that students receive the tools that are necessary to support their academic performance and growth on a continuous basis to facilitate positive outcomes. 

Chapter 1: Introduction to the Problem

Introduction

The topic evaluated was entitled “The effects of allergies on school age children’s performance.” This topic served as the key subject area for the capstone project and was explored in greater detail in order to emphasize the importance of different theoretical perspectives and strategies that are utilized in school settings in regards to children with allergies. Additionally, this topic was considered more closely in order to satisfy the requirements of the comprehensive capstone project.

Problem Statement

This topic is emerging because it is relevant in many children who face problems with allergies as they impact their quality of life and their ability to perform well in school. These elements are critical because they provide a greater understanding of allergies from the scientific and clinical points of view, and also support an examination of the psychological and behavioral aspects of this issue. Children who have been diagnosed with allergies face an uphill battle throughout their lives, particularly when their symptoms are exacerbated. These events may disrupt the normal routine and perhaps interfere with the ability of children to perform some physical activities. In addition, their level of focus and concentration may be disrupted to the extent that it interferes with their school and academic performance. These issues are instrumental in the lives of many children and continue to become increasingly important because allergies are on the rise in this population. For children who have allergies, there may be significant issues to consider in the context of their performance in school, how they interact with other children and their teachers, how they behave, their level of attendance, and other factors. Therefore, it is critical that school age children are evaluated on a more consistent basis when they exhibit allergies so that their parents, teachers, and school nurses are able to recognize symptoms, set a treatment plan into motion, and consider other factors that may influence their quality of life and wellbeing.

Rationale and Significance of the Study

The topic of allergies and their impact on school performance has been and remains highly relevant and timely because the number of children who suffer from allergies continues to grow in response to increased environmental pollutants, allergens, and irritants that plague the air and the environment as a whole. In addition, allergies are on the rise due to the manufacturing of processed foods and the treatment of foods with additives, preservatives, and other chemicals, all of which may pose a threat to children in the form of allergic reactions. These concerns impact how children respond to environmental conditions, foods, medications, and other stimuli that they are exposed to on a regular basis. It was important to address how children physically, emotionally, and psychologically react to allergies that occur throughout their lives; how they were impacted by a variety of symptoms; and the treatments available to treat allergies on a regular basis.

The role of allergies and their impact on behavior, attention span, and other factors that influence academic performance cannot be overstated. Children with allergies often require any number of modifications or accommodations in order to manage them effectively and without serious complications. However, their quality of life may be disrupted, thus challenging their ability to perform well in school. Children are required to meet at least the minimum standards set forth by academic experts and curricular activities in order to move forward in their academic careers. However, when allergies become a significant problem that disrupts daily activities, there may be difficult challenges to consider that could impact quality of life and the ability to focus and concentrate in the classroom and on homework assignments. When these circumstances occur, it is likely that a child’s grades will suffer and may set children back from moving forward to higher grades. Therefore, an understanding of allergies and their impact on school performance must be considered in order to establish strategies that will enable children who are allergy sufferers to achieve optimal academic performance.

From an academic perspective, children who have been diagnosed with allergies may find it difficult to focus and concentrate on the tasks at hand, particularly when they are sneezing, have watery eyes, have headaches, have runny noses, or a host of other symptoms that directly interfere with their physical wellbeing. If their allergy symptoms are frequent, then it is necessary to develop strategies to promote improved concentration and focus in spite of these symptoms. These efforts are essential to the discovery of new perspectives for teachers and parents so that they might collaborate to develop solutions for children to manage their allergy symptoms and also maintain their academic performance. This process addressed the issues that are most relevant to parents of children with allergies and how to best manage their academic needs in a suitable manner. This topic provided a basis for the exploration of allergies as a potentially severe and debilitating condition that not only reduces quality of life for children, but also interferes with their ability to be successful in an academic setting. This process is difficult for many parents to accept and for teachers to manage because they have a classroom full of students with different needs. The attention that must be paid to some children who have allergies is not always available; therefore, accommodations must be made that will address the questions raised by parents and provide a greater understanding of the teacher’s perspective in supporting their students with limited resources. This topic provided teachers, parents, and clinicians with opportunities to address possible collaborations aimed to have a positive impact on a child’s academic performance in a positive manner. In addition, it shed greater light on a topic that is not always considered to be a significant health concern. However, the ever-increasing prevalence of allergies warrants significant attention and understanding of the nature and severity of this health problem. It is expected that additional resources will be required to ensure that children who face allergies are provided with the attention and focus that is necessary to enable them to improve their academic performance. These resources must be provided so that children with allergies are able to sustain a strong quality of life in spite of these complications.

Summary of the problem.  Allergies have become increasingly common and prevalent in children who attend school. These children develop allergies in a number of different forms, such as allergies to foods, pets, molds, air, and other irritants. Children who have been diagnosed with one or more types of allergies are likely to experience symptoms from time to time, some more severe and more frequent than others. Therefore, it is important to determine how children attending school are impacted by allergies and the types of treatments that are available to assist them in alleviating the symptoms to improve their focus in school. However, it is sometimes difficult to alleviate symptoms or to predict when the symptoms might occur, as well as to determine their severity. Parents of children with allergies must identify the nature of the problem, seek medical attention as necessary, and determine how to best treat allergies in order to minimize symptoms and improve quality of life. Furthermore, it is important for children to be provided with a caring and nurturing environment in which they are able to manage their allergies and minimize their symptoms effectively.

For children who suffer from one or more forms of allergies, parents, teachers, and school nurses must work collaboratively so that a treatment plan is well established, is monitored on a continuous basis in order to ensure allergy-related symptoms are limited. These factors are essential to the discovery of new strategies and approaches that will be effective in supporting positive outcomes for children who suffer from allergies and who may experience difficulties that could impact their academic performance in a negative manner. Therefore, communication must be continuous and consistent regarding student performance so that if there are any observations that emphasize a decline in grades or achievement, they are managed properly and in a timely manner. The utilization of different approaches must be considered in order to accomplish the desired objectives in supporting a child’s health and wellbeing, as well as his or her academic achievement in the classroom setting.

Background information. Allergies are a common and challenging condition that impact many children throughout the United States. In 2010, approximately 10% of children had experienced hay fever, which was more common in the white population (American Academy of Allergy Asthma & Immunology, 2014). Furthermore, approximately eight % of all children had a food allergy between the ages of 6-18, and 39% of these children had experienced severe food reactions (American Academy of Allergy Asthma & Immunology [AAAAI], 2014). Of this population, 30% of children were allergic to more than one type of food, and peanuts served as the most common form of food allergy in children (American Academy of Allergy Asthma & Immunology, 2014). These factors represented a challenge to physicians, parents, and teachers in order to properly diagnose the allergic condition, establish a viable treatment plan, and implement this plan so that it does not significantly interfere with school activities and academic performance.

In recent years, a number of trends have been observed in children who have been diagnosed with allergies, including an increase in food, skin and respiratory allergies; a lower level of allergies in children of Hispanic descent; and a higher prevalence of allergies in children whose family incomes are well above the poverty level (Centers for Disease Control, 2014). These statistics indicated that there were significant factors to consider with respect to allergies and their prevalence in children and the latter statistic was interesting because it demonstrated that children in higher income households face a significantly greater risk of developing allergies (Centers for Disease Control, 2014). This was particularly alarming because the root of this problem was difficult to identify, particularly since there was a greater likelihood that children from higher income households would have improved access to healthier and natural foods that were not processed and that did not contain harsh chemicals or preservatives (Centers for Disease Control, 2014). It is important to evaluate these statistics further and to consider the challenges that children face as they obtain treatment and support for their allergies from physicians, school nurses, parents, and teachers.

Possible causes of the problem. Many children were diagnosed with allergies at a young age, and the causes of these conditions vary from one child to the next. For example, allergies may be caused by air pollutants, foods, animal dander, medicines, dust mites, grass, and other factors (American Academy of Pediatrics, 2014). Therefore, it was important to recognize the possible development of these allergies in children and to note that allergies may be difficult to treat in some cases (American Academy of Pediatrics, 2014). When there are a number of pollutants in the environment, these may place children at an even greater risk of developing allergies, thereby creating an environment whereby it may be difficult for children to be successful in managing their daily activities without interference (American Academy of Pediatrics, 2014). Based upon the challenges that were associated with the development of allergies and the risks associated with allergy-related symptoms, it is possible for children to be affected in many ways, some of which interfered with their academic progress and achievement. As a result, the cause of nature of allergies must be identified in a clinical capacity so that the appropriate treatment is provided and children are able to resume their normal activities as best as possible. Therefore, in spite of the many causes associated with allergies, a diagnostic and treatment strategy is essential in order to ensure that the desired academic outcomes are met.

Research Questions and Hypotheses

The proposed topic demonstrated allergies can be a contributing factor in weakened academic performance in some children; however, a number of other factors were also considered when addressing the impact of allergies on school performance. The following research question was considered: What are the effects of allergies on children’s performance in the school setting? Furthermore, this research question hypothesized that in some cases, allergies have a potentially significant impact on school performance in the form of declining grades, reduced concentration and focus, and other behavioral concerns.

Furthermore, this topic and the research questions also considered the value of a questionnaire instrument in order to obtain data and information regarding children with allergies and their level of school performance. Parents, teachers, and other school staff members were instrumental in determining the level of impact of allergies on a child’s performance; therefore, the perspectives and insights of these individuals was obtained in order the address the research question in greater detail. It was expected that this information would provide greater insight into allergies in children and the extent of the impact they have on their grades and overall school performance.

Definition of Terms

Allergic rhinitis: characterized by one or more symptoms including, sneezing, itching, nasal congestion, and rhinorrhea (Skoner, 2001).

Allergies: Reactions caused by an overactive immune system that can occur in a variety of organs in the body, resulting in diseases such as asthma, hay fever, and eczema (American Academy of Pediatrics, 2014).

Anaphylaxis: is a serious, rapid-onset, allergic reaction that may cause death (Brown, Mullin, & Gold, 2006).

Academic performance: is the outcome of achieving an educational goal (Bener, 2011).

Pollutants: the presence in the environment of an agent which is potentially damaging to either the environment or human health. As such, these agents include not only chemical, organisms and biological materials (Briggs, 2003).

Summary

Allergies have become increasingly common and prevalent in children who attend school. It was important to determine how children attending school were impacted by allergies and the types of treatments that were available to assist them in alleviating the symptoms to improve their focus in school. Furthermore, it is important for children to be provided with a caring and nurturing environment in which they are able to manage their allergies and minimize their symptoms effectively. Thus, parents, teachers, and school nurses must work collaboratively so that a treatment plan is well established, is monitored on a continuous basis, and is adjusted as necessary with the support of the family physician in order to ensure that allergy-related symptoms are limited.

Chapter 2: Literature Review

Introduction

The topic of allergies and their impact on school age children and academic performance has been explored throughout literature and represents a challenge in order to determine the extent of this impact and the variables that contribute to this problem in children. It was important to examine the body of available research in order to obtain greater insight into the challenges and issues associated with allergies in school age children and their impact on academic performance. A number of areas were considered that address this problem in greater detail, including a variety of strategies to explore the different dimensions of allergies and how they influence quality of life for school age children, including their ability to balance allergy-related symptoms and maintain strong school and academic performance. The following paragraphs will highlight some of the research that has been written regarding allergies and their impact on children and school performance.

Significance and Influence of Allergies

An article by Bener (2011) addressed the significance of allergies and their influence on school age children in the context of their academic performance. This article considered the potential risk of poor school performance when allergies are common and symptoms are exacerbated for a variety of reasons (Bener, 2011). It is believed that for some children, “Chronic illness may lead to school failure by increasing school absence during exacerbations” (Bener, 2011, p. 436). Therefore, it is important to identify the potential risks associated with allergies and the challenges that children face when their symptoms are frequent and severe enough to keep them out of school for periods of time (Bener, 2011). This has a negative impact on their grades and overall academic performance over time, particularly if school is missed on a frequent basis (Bener, 2011). Under these conditions, it may be difficult for students to catch up with their assignments and therefore, their grades might suffer in the process (Bener, 2011). These factors are important because they provide a more effective understanding of why missed absences as a result of allergy-related symptoms or episodes have a significant impact on student performance (Bener, 2011). This habit may repeat itself time and time again and cause even greater harm to student performance over time (Bener, 2011).

Turner and Kemp (2012) also addressed the significance of allergic rhinitis and its impact on the lives of children. This condition is typically characterized as hay fever, but it may be representative a number of different symptoms and allergens (Turner & Kemp, 2012). Children often experience different types of nasal complications that include sneezing and stuffy nose; therefore, treatment is necessary in order to minimize symptoms (Turner & Kemp, 2012). Nonetheless, this condition may have a significant impact on quality of life for affected children and may interfere with their ability to perform in school at the desired level (Turner & Kemp, 2012). Therefore, it is essential that children are seen by a physician and treated as best as possible so that other activities are not disrupted, such as school activities (Turner & Kemp, 2012). These efforts must play a role in determining how to best treat patients and provide children with the best possible framework for recovery and minimal symptoms to maintain their focus on school (Turner & Kemp, 2012). Children with allergic rhinitis may be absent from school during the spring and fall, and there are even correlates between this condition and Attention Deficit Hyperactivity Disorder (ADHD) (Jauregui et al., 2009). School absences are also higher in children with asthma, thereby demonstrating the need for a strategy to improve disease management in children (Moonie, Sterling, Figgs, & Castro, 2008). The ability to properly function in the school environment also requires adequate sleep, which is often difficult to sustain when allergies are evident and causing severe symptoms (Meijer, 2008).

Factors and Risks Associated with Allergies

An article by Muraro et al. (2010) addressed the importance of different factors that are associated with allergies and their negative impact on quality of life in school age children. This article considered the following:

Allergy at school manifests in multiple ways: eczema, bronchial asthma (hereafter asthma), rhinitis and/or conjunctivitis, food allergy and less commonly venom allergy and urticaria. Children may present with various symptoms such as wheezing and dyspnea related to asthma, which may be triggered by allergen contact, airway infection or physical exercise. (Muraro et al., 2010, p. 681)

These factors demonstrate that it is essential for parents, teachers, nurses, physicians, and other personnel to collaborate and address the potential risks associated with allergy-related symptoms in the school environment not only for the student in question, but also for other children (Muraro et al., 2010). In addition, it is very possible for some children to experience a food allergy at school, with some reactions presenting as anaphylaxis (Muraro et al., 2010). In many cases, schools are unprepared to manage these events, thereby placing children at serious risk of they are not properly treated (Muraro et al., 2010). Therefore, it is important for schools to establish strategies and guidelines that will govern these situations so that children do not suffer any permanent consequences (Muraro et al., 2010). Teachers and other staff members should be sufficiently prepared to manage the challenges that are associated with allergic responses and symptoms if they take place in the school environment so that children are treated in a timely manner to minimize their symptoms and promote recovery (Muraro et al., 2010). These efforts are instrumental in shaping outcomes for children and in enabling them to experience improved quality of life and the potential for greater academic achievement (Muraro et al., 2010).

Mir, Panjabi, and Shah (2012) considered the potential risks associated with allergic rhinitis for children of school age. This article supports the belief that allergic rhinitis is not properly managed in many children and therefore, they face the risk of significant symptoms and other challenges that are difficult to manage (Mir et al., 2012). From this perspective, it is likely that children will suffer in school over time when their symptoms are exacerbated and treatment is not immediate or effective (Mir et al., 2012). It is known that

Irritability, sadness, impairment of sleep and limitation of activities at school as well as home are often seen in these children. AR results in day-time fatigue and impairment of cognition and memory in children which significantly affect the learning process and thus impacts on school performance and all these aspects upset the family. (Mir et al., 2012, p. 93)

This is a critical challenge for school personnel and parents because they must determine how to best manage the symptoms that children present so that school activities and assignments are not disrupted (Mir et al., 2012). With this population, there must be a greater focus on the strategies that are necessary to minimize the impact of symptoms so that school performance is not disrupted (Mir et al., 2012). However, many physicians who treat children do not take this condition seriously or do not take the steps that are required to develop a comprehensive treatment plan (Mir et al., 2012). As a result, children experience a reduced quality of life and may find it difficult to sustain adequate academic performance in school (Mir et al., 2012). The issue of quality of life is significant and requires critical knowledge to provide children with the treatment and services that will improve their lives (Felder-Puig, Baumgartner, Topf, Gadner, & Formann, 2008). Children must receive the level of support and focus that is necessary to overcome these conditions and to achieve a greater quality of life that will filter down to an improved level of academic performance (Mir et al., 2012). Quality of life for children with any type of chronic illness must be considered and evaluated so as to not minimize the condition. Additionally, the conditions must be embraced so that the children are provided with the best possible resources to improve their wellbeing (Taylor, Gibson, & Franck, 2008).

Food Allergies

Cummings, Knibb, King, and Lucas (2010) addressed the importance of food allergies and their impact on children. This article considered the different risks associated with food allergies and the common practice methods that must be considered in order to identify food allergies and manage them as best as possible, given the limitations that children face in school and in other environments (Cummings et al., 2010). Food allergies may be particularly difficult to manage in the school setting if those working with children are not aware of these allergies, thereby potentially contributing to an allergic reaction (Cummings et al., 2010). These factors must be considered in greater detail because they convey the importance of knowing the nature and extent of children’s allergies so that they do not face unnecessary risks in the school environment (Cummings et al., 2010). Food allergies may have a substantial impact on quality of life; therefore, they must be considered comprehensively in order to ensure that all possible methods are explored to prevent food allergies from taking place (Cummings et al., 2010). When allergic reactions take place, they must be properly managed in a timely manner to prevent further complications or even mortality in some extreme cases (Cummings et al., 2010).

Pet Ownership

An article by Carlsen et al. (2012) considered the relevance of pet ownership and whether or not it impacts allergy development in school age children. This article supports the belief that there is no specific relationship between pet ownership at a young age and the development of allergies and related symptoms (Carlsen et al., 2012). Pets, however, may contribute to the development of allergies if individuals are vulnerable to dander and other irritants that pets introduce into the household (Carlsen et al., 2012). From this perspective, it is important to recognize the value of understanding how pet allergies contribute to the general allergic state, even though the risk is not different from the risks associated with other types of allergies (Carlsen et al., 2012). Clinicians must recognize the potential impact of allergies on quality of life for children, particularly when they are pet owners and are vulnerable to pet fur and dander (Carlsen et al., 2012). These elements are important contributors to the development of new perspectives to address pet ownership in families with children who have an allergy to these pets (Carlsen et al., 2012). If the symptoms are severe enough, they may represent a more serious challenge to children in the school environment when they are unable to overcome the symptoms that occur (Carlsen et al., 2012). These efforts require a greater understanding of the severity of pet allergies in some children and the potential risks that are associated with poor school performance when allergy symptoms are prevalent (Carlsen et al., 2012).

Conditions and Symptoms

Children who experience a chronic condition such as allergies face an uphill battle in their efforts to achieve optimal quality of life; as a result, they often face physical, emotional, and behavioral challenges when chronic illness is present (Pinquart & Teubert, 2012). Some children with chronic illness may possess some degree of impaired functioning, which includes poor or limited academic performance (Pinquart and Teubert, 2012). Therefore, it is expected that some children will experience setbacks in school that could limit their academic growth and progress:

A visible physical illness is a risk factor for peer rejection and bullying…which further limits opportunities for social functioning or receiving peer support in the case of academic difficulties. Finally, behavior problems associated with chronic illness, such as aggressive behavior or depressive symptoms…may affect social and academic functioning. (Pinquart & Teubert, 2012, p. 377)

As a result, it is critical that children who have allergies and possess visible and frequent symptoms may experience issues at school that contribute to setbacks in the academic setting (Pinquart & Teubert, 2012). The lesson to be learned is that children with allergies should be provided with additional assistance as necessary so that they are able to function more consistently and normally to prevent serious complications or other factors that could stunt their academic growth and achievement (Pinquart & Teubert, 2012). Some children with a chronic condition such as allergies may appear to be behind in their academic performance and in other areas, which may be indicative of the lack of adequate attention paid to their needs (Irwin & Elam, 2011). In these cases, there is great potential in the use of school counseling services to assist in managing children with a chronic condition to improve their quality of life at school (Hamlet, Gergar, & Schaefer, 2011). In a similar context, school nurses are likely to offer much needed support to these children when symptoms and other health concerns are evident (Engelke, Guttu, Warren, & Swanson, 2008). Without these support systems in place, it is possible that children may experience developmental and performance deficiencies that are difficult to overcome (Blackman and Gurka, 2007).

Children with allergic rhinitis face a number of critical challenges as they attempt to lead normal lives in school and at home (Civelek et al., 2010). These children face an uphill battle as they attempt to be productive in school when they experience symptoms that limit their concentration (Civelek et al., 2010). It is important for members of society to obtain a greater awareness of allergies in children so that they are able to obtain the support and guidance that is necessary to ensure that their school performance is optimal (Civelek et al., 2010). However, this process is often disrupted by a limited understanding of the impact of allergies on children, including their attention span, language growth, and awareness, all of which could halt their academic growth and development (Civelek et al., 2010). Children must be provided with a framework that is necessary to identify the risk factors associated with symptoms and the ability to prevent poor outcomes as a result of symptoms and the allergic condition as a whole (Civelek et al., 2010).

Children with a chronic illness such as asthma or allergies are likely to miss school more often than other children, and this is a significant limitation for their academic development (Akinbami, Parker, & Merkle, 2010). This group may require special attention and support from teachers, parents, and other school personnel so that children do not fall behind in their academic achievement (Akinbami et al., 2010). Nonetheless, when children miss school frequently as a result of their allergies, they are likely to experience difficulties at school that may dampen their growth in the school setting (Akinbami et al., 2010). It is important for teachers and parents to become educated regarding the potential academic risks associated with allergies and to determine how to best move forward in establishing a framework that will encourage students who may become discouraged and address the difficulties that they face in the school setting (Akinbami et al., 2010). Those children who miss school frequently as a result of allergies may require special accommodations so that their academic growth is not disrupted for lengthy periods of time (Akinbami et al., 2010).

Best Practices

Guidelines established by the American Academy of Pediatrics (2012) recognize the importance of the physician in the school setting. However, this role is not recognized and accepted on a widespread basis, due in large part to limited resources and regulations that exist to govern physicians in schools (AAP, 2012). It is known that

Despite the value of coordinating health and education, physicians are not effectively and consistently involved in schools across the nation. As a result, U.S. children have varying levels of medical support and safety, depending on the community in which they live. (AAP, 2012, p. 178)

These findings suggest that additional frameworks are required to ensure that physicians are considered as a possible contribution to the school setting as a means of providing much-needed benefits to children of school age (AAP, 2012). This is particularly relevant for children with allergies who experience significant challenges in the school environment that interfere with their school activities (AAP, 2012). It is likely that the incorporation of a physician into the school setting would provide another level of support to students in need of clinical guidance for allergies (AAP, 2012).

Specific guidelines have been established to manage children with food allergies, including the issues raised in the school environment (Burks et al., 2011). Food allergies cannot be treated; therefore, they must be avoided as best as possible by implementing a comprehensive strategy that is designed to facilitate effective results and minimal complications (Burks et al., 2010). The National Institute of Allergy and Infectious Diseases established a set of guidelines that are designed to diagnose and manage food allergies more effectively, and these include the recognition of foods that contain potential allergens that may cause symptoms (Burks et al., 2010). Furthermore, it should be noted that “Most children with food allergy eventually tolerate cow’s milk, egg, soy, and wheat; far fewer will eventually tolerate peanuts, tree nuts, fish, and shellfish” (Burks et al., 2010, p. 957). This indicates that there is a need to recognize types of foods and additives that may lead to food allergies, particularly in children, and to attempt to prevent these interactions as best as possible (Burks et al., 2010). These efforts must be established on a continuous basis and represent a means of developing new perspectives to ensure that when children are at school, they are not exposed to foods to which they are allergic under any circumstances, as this could lead to serious complications if left untreated (Burks et al., 2010). The primary strategy involves the creation of an environment whereby food allergies are well known and recognized by parents, teachers, and children so that if they are exposed to a known food that causes an allergy, the appropriate steps are taken to minimize the impact of this exposure to prevent complications and symptoms (Burks et al., 2010).

In the elementary school setting, it is necessary for teachers and school personnel to establish guidelines to manage children’s food allergies (Russell & Huber, 2013). There is often much anxiety associated with school for children with food allergies, such as the following: “When children with food allergies start elementary school, this transition can be quite anxiety provoking for parents/caregivers. Schools may be perceived as allergen ubiquitous settings coupled with staff having varying awareness and training regarding food allergy and anaphylaxis” (Russell & Huber, 2013, p. 290). These findings suggest that it may be difficult for children to adjust to the school setting if they have one or more types of allergies because this environment might not be as allergy-proof as the home (Russell & Huber, 2013). Therefore, it is important for a collaborative effort to be established to address food allergies in school age children more effectively so that their needs are met and their risk of food-related allergies is minimal (Russell & Huber, 2013). It is necessary to develop new approaches to improve outcomes for school age children who suffer from food allergies because the potential risks associated with this condition may be severe in some cases (Russell & Huber, 2013).

It is also important to establish an effective understanding of the behavioral components of allergies in school age children, as these children often require special attention or focus to gain a greater level of comfort in their own skin (Stewart, Masuda, Letourneau, Anderson, & McGhan, 2011). From this perspective, it is important to identify the resources that are available to children who face allergies and to be exposed to other children with allergies to gain support from their peers (Stewart et al., 2011). Children with allergies often become frustrated with their condition, particularly if they cannot function at the same level as other children; therefore, they must be provided with a nurturing and supportive environment where they do not feel along or isolated (Stewart et al., 2011). It is expected that this process will be achieved through the development of peer groups and other support systems that will have a positive impact on their wellbeing (Stewart et al., 2011). This, in turn, will demonstrate the importance of new perspectives that may improve academic performance for some children (Stewart et al., 2011). A model of coping must be considered so that children are better able to understand the nature of their allergies and the options that they have to manage them as best as possible (Stewart et al., 2011).      

Some children with allergies should also be evaluated for possible symptoms that may be attributed to depression and anxiety, because there is a greater risk of developing these conditions when allergies disrupt quality of life (Lu et al., 2012). When school age children are symptomatic, they might become anxious, tense, embarrassed, frustrated, and annoyed by their condition, all of which may contribute to negative behaviors and other concerns that could impact their academic performance in different ways (Lu et al., 2012). Therefore, it is necessary to develop tools that will facilitate the measurement and screening for possible depression and/or anxiety in children who face allergies (Lu et al., 2012). These factors are critical because they provide a greater understanding of the needs of children that may go undetected because significant focus is placed on clinical allergy-related symptoms (Lu et al., 2012). It is expected that with additional examination of the possible emotional and psychological complications of allergies, new methods and strategies will be considered to accommodate children with allergies so that the comprehensive nature of their conditions are fully explored (Lu et al., 2012). It is the collaborative responsibility of parents, teachers, school nurses, and other individuals to take the steps that are necessary to explore new insights into the emotional and psychological impacts of allergies on quality of life in school age children so that their behaviors and level of academic performance are better understood (Lu et al., 2012).

Finally, allergies in school age children reflect a continuing upward trend to establish new perspectives and guidelines that govern oversight and management of this condition in the school setting (Gentile, Bartholow, Valovirta, Scadding, & Skoner, 2013). Since allergies continue to rise in school age children, it is important to determine the extent of this impact and the possible challenges that children face as they continue to experience symptoms (Gentile et al., 2013). In the school environment, allergic symptoms are unwelcome because they may disrupt the classroom and lead to a loss of focus and concentration; therefore, it is necessary for teachers to recognize the impact of these disruptions and to make all possible efforts to minimize the symptoms as best as possible through strategies that focus on children with allergies (Gentile et al., 2013). It is expected that children with allergies will continue to experience significant challenges that could halt their academic progress in some cases, thereby leading these children down a difficult path that cannot be easily overcome (Gentile et al., 2013). It is important for individual teachers and parents to collaborate regarding improvements that could be made to accommodate their students in the classroom so that their academic performance is not significantly disrupted (Gentile et al., 2013). However, this is a difficult task to achieve and may limit the progress that children are able to make with respect to their school and homework assignments (Gentile et al., 2013). Teachers must pay close attention to these students in order to recognize when they are struggling so that they are provided with a framework to enhance their growth and mask their symptoms through a greater focus on schoolwork (Gentile et al., 2013). Students will benefit from teacher-based strategies to improve their academic performance; however, these strategies must be communicated to parents so that they are aware of the steps that are being taken to ensure that student needs are met in a timely manner (Gentile et al., 2013).

Summary

Allergies are a challenging condition that affects many children of school age on a regular basis. They are significant in the lives of these children because the symptoms they experience may be indicative of academic difficulties in the school setting. Children with frequent symptoms my lose focus more quickly and may find themselves struggling to manage their schoolwork on a consistent basis. It is important to establish a greater understanding of these challenges and for parents, in collaboration with teachers and other school personnel, to develop strategies that will accommodate children with allergies and related symptoms. It is expected that these factors will play a critical role in shaping outcomes for children and in determining how to best move forward so that their academic achievement is optimized and their setbacks are limited. Children with allergies also face other potential limitations at school, such as difficulties in making or keeping friends and participating in sports and other extracurricular activities. Each of these events may have a negative impact on their overall growth and development in different ways, as they may exhibit negative behaviors, develop anxiety or depression, or experience other challenges that must be addressed in a proactive manner to promote greater wellbeing and growth. However, academic achievement must be considered on a more consistent basis and should be a primary focus for parents of children with allergies and related symptoms. The literature that has been presented demonstrated that it is important for children to obtain the support and guidance that is necessary to minimize academic limitations and to promote growth and change within the academic setting. It is expected that students who are provided with a support system will experience greater academic achievement in school versus those who do not receive this level of support on a continuous basis from their parents, teachers, and school nurses.

Chapter 3: Methodology

Introduction

Children who suffer from allergies on a regular basis often experience problems associated with academic performance in the school environment. This chapter addresses the methodology utilized for obtaining such data in this quantitative study. Specifically, it presents the setting, participants, research design, description of instruments and tools, data collection, data analysis, and human subject’s protection.

Setting

The proposed study included parents of enrolled students, ages 5-11 and teachers within a K-5 charter elementary school in the Los Angeles area. All grade levels with the exception of kindergarten were comprised of two classrooms each. The entire student body was comprised of 410 students, including 40%White, 25% African American, 23% Asian, and 12% Hispanic or Latino. The student body included the following makeup: 1) Kindergarten: one class of 43 students; 2) Grade 1: 68 students; 3) Grade 2: 77 students; 4) 3^rd and 4^th Grades: 73 students each; and 5) Grade 5: 76 students. Throughout the school, there were approximately 780 parents that were considered for the study within the age range of 24-50, along with a principal and 12 classroom teachers. Three of the classroom teachers filled the roles of resource teacher, coordinator, and specialist, respectively. There were two members of the support staff in the front office, a cafeteria manager, a part time school nurse, and a part time school psychologist.

Participants

For this research study, the participants had to be able to provide a relevant contribution to the overall study and research direction. Therefore, the chosen participants for this study included the aforementioned parents, guardians, administrators, teachers, and other school personnel within the school that worked with these children on a daily basis. All parents of students at the selected school, as well as teachers and other school personnel, were all considered for participation in the study to facilitate a variety of responses and to remove any biases. All participation was voluntary and all participants were asked to provide their consent to participate. In addition, they were notified that they could withdraw from the study at any time, for any reason.

Research Design

A correlational research study addressed and fostered a greater understanding of the challenges that children face in the classroom setting when allergies are a factor in their school lives. The two primary variables considered were evidence of allergies and related symptoms, as well as level of school performance for students under these conditions. It was important to identify these variables and to gauge their relevance in the context of the questionnaire so that the desired responses were obtained from the chosen participant population.

Additionally, this study utilized the quantitative data collection method. This method was appropriate in this case, again, because it offered a comparison of two variables that appear to be related to each other in a unique manner. These concerns were relevant because they provided an improved understanding of the challenges that students face as they experience allergies and related symptoms. By addressing these concerns using feedback from teachers and parents, it was possible that additional issues would be introduced and supported by evidence in order to accomplish new objectives to enhance student outcomes. Furthermore, this research method enabled the researcher to determine if there was a specific and direct relationship between allergies and academic performance as this might have shed some light on the issues that were most relevant to students, teachers, and parents in addressing allergies on a regular basis. This was a challenging yet appropriate relationship to consider, given the issues that often emerge in the classroom when these students struggle academically in balancing their allergies and their school assignments in the classroom setting and in the home environment.

Description of Instruments or Research Tools

This quantitative study research design involved a questionnaire instrument that conveyed the objectives of the study and its purpose in an effective manner. The questionnaire was properly worded and provided insight into the topic in question without any form of bias. All questions were professionally written and easily understood by the participants. In addition, their content demonstrated the importance of the topic in question and in supporting the desired outcomes to enhance learning and improve performance for students who experience problems associated with allergies. Most importantly, the questionnaire provided a basis for exploring new insights into the growth of the topic and to develop strategies to support student learning when allergies may be a limiting factor in this process.

The questionnaire instrument was a cross sectional survey. A cross sectional survey allowed for a true sampling of the participant pool. The questionnaire was standardized for all participants, with closed-ended questions. A questionnaire was chosen because it is reliable and valid in its contents and its measurability. Additionally, a questionnaire does not demonstrate any type of bias and the questions were not leading or directed towards a biased response. With this in mind, the questionnaire did not aim to convey any type of bias. Furthermore, the questionnaire reflected stable responses that were consistent. In other words, if the questionnaire was redistributed to the same population, the second set of responses should be consistent with the first.

Data Collection

The questionnaire demonstrated the significance of the study objectives and the relevance of allergies in the school age population and their influence on school performance. The study was distributed to parents and faculty at Open Charter Magnet School and emphasized the prevalence of allergies in the student population. In the initial stages, the response to the questionnaire was quite slow, as only five completed consent forms and questionnaires were submitted. Historically, the parents were typically responsive to inquiries. Weeks prior to the distribution of the survey, the school transitioned to a new electronic format for the weekly newsletter, which was in contrast to the traditional format of sending materials home with the children. The original intent was to send a paper copy of the questionnaire and consent form home with the children, but given the new platform for delivering the school newsletter and pertinent information, the participants of the study were required to print out the consent and questionnaire from the website, sign and complete them at their leisure. This may have contributed to the low response rate.

After a recommendation by the principal to distribute the same questionnaire online, a questionnaire using the Surveyshare.com® portal was created, with the anticipation of receiving a greater number of responses. Reminders via the Yahoo group sponsored by the school were sent out two days after the survey was posted online.  A total of 21 responses were recorded online. In total, 26 responses were collected, with a varied number of responses to the questions asked throughout the survey.

Data Analysis

The survey questionnaire used descriptive questions in order to determine the significance of allergies in the target population. The researcher used the survey instrument as a means of obtaining responses to the questions, and the website automatically derived the number and percentage of responses to each answer.

Descriptive statistics was used to describe and summarize the data collected. Tables and graphs illustrated the data that corresponded to the questions that were asked in the survey instrument. Additionally, the tabulated, graphical, and statistical commentary provided summarized data on the context of the question, the responses to each answer, and the total number of responses, along with a percentage for each response. The initial questions described basic demographic information, while additional questions addressed specifics regarding the subject and its impact on the target population. Crosstab tables were developed to illustrate the comparisons of the prevalence of allergies and symptoms against race, gender, and grade.

Human Subjects Protection

This research study required full support from the principal prior to participant selection and rolling out the study to the desired participants. Prior to seeking the approval of the principal, the researcher completed the National Institutes of Health (NIH online training on the Protection of Human Subjects (see appendix B). Additionally, approval from the Institute Review Board of Western Governors University was sought and obtained. Informed consents were obtained and documented both on paper and electronically. Participation in the study was completely voluntary and participants were able to withdraw from the study at any time. Both versions of the questionnaire (paper and on-line) did not have any personal identifiers to ensure anonymity of the participants. All data collected was reviewed solely by the researcher, kept within the researcher’s possession, and uploaded to a password protected computer. All data collected will be purged one year after completion of the study.

Summary

Collectively, these steps were vital in ensuring study validity and appropriateness for the desired population. These issues were addressed prior to obtaining consent from participants and distributing the questionnaire to the chosen population. This process required an important understanding of the school environment and the challenges that might be encountered during study implementation, as well as the issues that might not be anticipated upon retrieval of the study results.

Chapter 4: Findings

Overview

The purpose of the study was to determine if allergies had an impact on academic performance in a group of school age children. The study was divided into a number of questions that were designed to address demographic information and specific questions associated with allergies as represented within the student population. The questions elicited the perspective of faculty members and administrators, as well as parents, in order to determine how allergies influence this population, including classroom focus and the ability to perform the required assignments without difficulty.

Analysis of Data

The survey instrument was available in an electronic format using the SurveyShare ® website. A total of 26 individuals participated in the study, with 25 parent/guardian participants and one faculty/administrator participant, for a response rate of 100%. In addressing the race of the children, within the four groups, 53.8% of the children were White, 19.23% were Black, 23.08% were Asian, and 23.08% were Hispanic. This was further broken down to represent children of mixed races, as presented in Table 2.

The children were also in a number of different grades, as 19.23% were in Kindergarten, 23.08% were in 1^st Grade, 15.38% were in 2^nd Grade, 19.23% were in 3^rd Grade, 19.23% were in 4^th Grade, and 23.08% were in 5^th Grade. Exactly 50% of the children were boys and 50% were girls. The demographic data is presented in the Tables 1 through 5 below. Crosstab tables comparing the prevalence of allergies and symptoms against race, gender, and grade are illustrated in Figures 1 and 2. A comprehensive interpretation of the responses to questions 8 through 17 is illustrated in Figure 3.

Almost all of the participants (n=25) were parents or guardians of students at the school, with only one participant (n=1) a member of the faculty/administration of the school. This is noted in Table 1.

Table 1: Participants

Based upon the question of race, the responses were divided, as a combination of races were represented in the study, including Whites (n=9), Blacks (n=4), Asian (n=3), Hispanic (n=5), White/Asian (n=3), White/Hispanic (n=1), and White/Black (n=1). This information is noted in Table 2.

Table 2: Race/Ethnic Background

The children’s gender was evenly divided, with half boys (n=13) and half girls (n=13) represented in the study. This information is noted in Table 3.

Table 3: Gender

Based upon the question of student grade level, the responses were also divided, as a number of grades were represented in the study, including Kindergarten (n=5), 1^st Grade (n=6), 2^nd Grade (n=4), 3^rd Grade (n=5), 4^th Grade (n=5), and 5^th Grade (n=6). This information is noted in Table 4.

Table 4: Grade Level

With respect to the grade taught by the teacher, almost all of the participants (n=25) were parents or guardians of students at the school, with only one participant (n=1) teaching Kindergarten/1^st grade. This is noted in Table 5.

Table 5: Grade Taught

The data of participant responses specifically related to the presence of allergies symptoms and their related behaviors is illustrated in Tables 6 through 16.

Question 6 asked of the participants: Does your child(ren) experience allergies and related symptoms, at school and/or at home? The responses were fairly evenly divided, as 53.85% (n=14) responded yes and 46.15% (n=12) responded no. The faculty/administrator response to the observance of allergy symptoms (question 7) was zero, as a number of responses were received (n=14) only from parent/guardian participants. This information is noted in Table 6.

A cross tabulation of the distribution of the participants’ racial/ethnic background was performed against the prevalence of allergies and symptoms observed in school and/or at home to determine if there are any correlating relationships among the two (see Figure 1).

Figure 1: Prevalence of Allergies and Symptoms

Figure 1: Prevalence of Allergies and Symptoms Distributed by Race/Ethnicity

Question 8 asked the participants: Have you noticed any change in grades or academic performance that coincides with allergies? With respect to noticing any changes in grades or academic performance associated with allergies, 100% of the responses to this question answered no (n=14). This information is noted in Table 7.

Question 9 asked the participants: Does the child have trouble concentrating when allergy symptoms are observed? In response to observing children and their level of concentration when allergy symptoms are observed, 78.57% responded yes that a change is observed (n=11), while 21.43% responded no, as they did not witness any changes (n=3). This information is noted in Table 8.

Question 10 asked the participants: Does the child find it difficult to complete tasks when allergy symptoms are observed? In response to completing tasks when allergy symptoms are observed, 78.57% responded that it is difficult for a child to complete a task (n=11), while 21.43% responded that it was not difficult (n=3). This information is noted in Table 9.

Question 11 asked the participants: Does the child display behavioral changes from his or her normal self when he or she experiences allergy symptoms? With respect to behavioral changes, it was observed that 35.71% witnesses changes in normal behavior with allergy symptoms (n=5), while 64.29% did not witness any personality changes (n=9). This information is noted in Table 10.

Question 12 asked the participants: Does the child become frustrated or agitated when their allergy symptoms are evident? With respect to frustration or agitation, it was observed that 42.86% noticed a child becoming frustrated or agitated when allergy symptoms are present (n=6), while 57.14% did not notice any frustration or agitation (n=8). This information is noted in Table 11.

Question 13 asked the participants:  Does the child react negatively to other students or siblings when allergy symptoms occur? With respect to negative reactions to other students or siblings, 14.29% responded that they observe negative reactions (n=2), while 85.71% have not observed negative reactions (n=12). This information is noted in Table 12.

Question 14 asked the participants: Does the child find it difficult complete written assignments when allergies symptoms are observed? Relative to the completion of written assignments, 50% observed that students find it difficult to complete assignments when allergies are evident (n=7), and 50% observed no difficulties in completing assignments (n=7). This information is presented in Table 13.

Question 15 asked the participants: Does the child find it difficult to complete reading assignments when allergies symptoms are observed? Relative to the completion of reading assignments, 35.71% responded that it is difficult for children to complete reading assignments (n=5), while 64.29% did not notice any difficulties in completing reading assignments (n=9).  This information is presented in Table 14.

Question 16 asked the participants: Does the child experience problems when taking tests in the classroom?  Relative to taking tests in the classroom, 7.14% responded that a child has problems when taking a test (n=1), while 92.86% did not notice any problems (n=13). This information is presented in Table 15.

Question 17 asked the participants: Does the child take medications for allergy symptoms? Finally, in taking medications for allergies, 64.29% responded that children take medications (n=9), while 35.71% responded no (n=5). This information is presented in Table 16.

Figure 2: Comparison of Medication Taken

A second cross tabulation on the distribution of the participants’ racial/ethnic background was performed against the use of medications for allergy symptoms (see Figure 2).

Figure 2: Comparison of Medication Taken by Race/Ethnicity

Results and Interpretation

Seventeen questions were provided in the survey for completion, and a number of responses demonstrated that although children experience allergies and related symptoms, they do not seem to experience significant problems in the school setting that limit their ability to perform at the expected academic level. This demonstrated that although allergies are prevalent in many school age children, they do not necessarily experience significant problems when their allergy symptoms are prevalent. Many of the parents who participated in the survey observed some issues with their children and their performance in school, such as task completion, trouble with concentration, frustration and agitation in completing assignments, and struggles in completing written assignments. Although the responses were varied to some degree (see Figure 3), they established an understanding of the issues that many children experience when allergies become symptomatic. In these cases, children may experience a variety of symptoms that could essentially impact their school performance in different ways.

It is important to recognize that when children struggle in school as a result of allergies, it is necessary that parents and faculty should work collaboratively in order to provide children with an environment that will stimulate their academic growth and development on a continuous basis. These efforts are necessary because allergy-related symptoms are likely to have an impact on children from time to time, thereby creating a challenging environment for these children in their efforts to complete their school assignments on time and with the best possible academic performance at all times. These efforts will provide an opportunity to address school performance as it relates to allergy symptoms on an individual basis so that students do not fall behind in the classroom and are able to keep up with their studies as best as possible. These efforts will also contribute to the development of new perspectives that will ensure the ability of parents and faculty to be successful in providing students with an environment that will be supportive when allergy symptoms occur so that school-related activities are not disrupted. Ions

Figure 3: Responses o

Figure 3: Results of Questions 8-17

Summary

The results from the survey instrument demonstrated that allergies in school age children have a varied impact on their ability to perform effectively in an academic setting. With a number of variable responses, it is necessary to address the problem of allergies in the school age population on a more comprehensive basis so that there are sufficient opportunities for growth and change within the learning environment. These factors are instrumental in shaping outcomes and in providing a basis for the exploration of new ideas and approaches to recognize the potential needs of children with allergies when they are in the classroom setting. Through the collected data sample, there was an improved understanding of the impact of allergies on school-age children. However, future studies are necessary to determine the scope of this relationship for a larger segment of the population.

In addressing the research question regarding allergies in the school environment and their impact on children, the survey and subsequent data collection processes did not represent a widespread and meaningful approach to the topic, due in large part to the small sample population. Therefore, the study was limiting in that the research question was not addressed on a comprehensive basis in a larger population setting. The current study population was too small to establish an accurate determination of the sample population in addressing the research question. With a larger population sample, it is likely that the study will demonstrate a greater level of effectiveness and will determine if allergies have a significant impact on school age children and their performance in the school setting. Chapter 5 will present discussion, implications, limitations, and recommendations, related to the study findings.

Chapter 5: Discussion and Conclusions

Introduction

Many children in modern society face challenges as they attempt to obtain a successful education, often due in large part to learning deficiencies or health concerns. It was important to recognize the correlation between an ever-increasing focus on allergies and their impact on young children. In particular, the school environment represents a challenge for many children who struggle to achieve a strong academic performance in the classroom setting. In some cases, this may have attributed to the presence of allergies and their impact on health, wellbeing, and general quality of life. Children in the school environment were evaluated in the context of allergies and whether or not related symptoms impact school performance. Allergies impacted student performance in the form of distractions and lack of focus and concentration during symptom flare-ups, and often were a primary concern of teachers and parents of children with allergies. When these symptoms have an impact on school activities, teachers must gauge this impact and determine the appropriate course of action when necessary.

Discussion

The study introduced a number of allergy-related factors that have a tendency to impact student performance in the classroom setting, particularly as students struggle with reading, homework assignments, examinations, and their general focus. These factors were of critical importance in the school environment because any type of distraction may lead to negative academic outcomes. The responses to the survey instrument determined that there were significant factors associated with the creation of an environment that supports effective student performance, in spite of allergies and related symptoms. Most importantly, concentration and focus appeared to be of primary concern, particularly when students experience allergies at school. Based on the responses provided on the questionnaire, there was also concern in the home environment regarding the prevalence of allergies, as many children experienced symptoms from time to time, particularly during different parts of the year. The study results indicated that allergy symptoms are a cause for concern and provide a basis for exploring new insights regarding academic performance. This matter was disconcerting for some parents and teachers because children who otherwise might possess great academic potential may not perform at this level due to allergies.

Students who perform poorly or lower than the anticipated level may be observed as distracted and unable to focus on the tasks at hand, based upon the survey results. This facilitates their struggle in areas such as reading, writing, test taking, and homework assignments. This process required a greater understanding of teacher-based strategies and interventions that might have a positive impact on students suffering from allergies, particularly during the school day. These factors are likely to be effective in supporting greater academic achievement, in spite of the issues that were prevalent for this student population. Teachers must identify resources that are available to support students and also demonstrate their ability to be effective in communicating the needs of students to their parents so that a collaborative approach is identified.

Implications

This study demonstrated that allergies may pose a problem for some students in their efforts to perform at the desired academic level, and this may place a significant strain on their academic performance over time. The study possesses a number of strengths in that it supports a greater understanding of allergies and their impact on student learners, as well as a means of increasing the focus on this population to meet their needs more effectively. In addition, the study supports the ability of students to have a greater focus on their studies if their allergies are under better control with medication or other resources. The information provided in this study is noteworthy because it reflects the importance of recognizing allergies in younger children as a potentially serious and distracting problem that could impact their overall academic performance. Therefore, a combination of factors must be considered, including a focus on proper diagnosis and treatment in order to ensure that children maintain greater control over their symptoms in the classroom setting.

This study has implications for future research regarding allergies, as there is an important opportunity to develop strategies for students when they experience symptoms in order to restore their concentration and focus. These efforts will support the development of new strategies to improve student academic performance, but not without consideration of their impact on a larger audience. It is important to apply future studies to a larger and more diverse population so that there are a sufficient number of responses available to have a significant impact on practice settings.

Implementation Problems

As the study began, it was difficult to disseminate the study to the desired participant population, due to a change in process at the school regarding the distribution of information regarding the survey to parents. Thus, interest and response to the survey were very slow and less than desirable. This was an important factor in the number of responses that were received and the number of surveys that were analyzed. As a result, the implementation effort went less smoothly than anticipated, and the results demonstrated a low response rate. By making the survey online, there is a greater likelihood that it will attract a larger group of participants. This could be achieved by providing detailed information regarding the study to parents via email, including the purpose of the study, its benefits, and its impact on their students. This supports parental involvement in the lives of their children and a greater focus on student achievement in conjunction with health and wellbeing.

Limitations

The study also possessed a number of limitations that impacted the outcomes that were generated. In the initial stages, the response to the questionnaire was quite slow, as only five completed consent forms and questionnaires were submitted. Weeks prior to the distribution of the survey, the school transitioned to a new electronic format for the weekly newsletter, which was in contrast to the traditional format of sending materials home with the children. The original intent was to send a paper copy of the questionnaire and consent form home with the children, but given the new platform for delivering the school newsletter and pertinent information, the participants of the study were required to print out the consent and questionnaire from the website, sign and complete them at their leisure. This may have contributed to the low response rate.

After a recommendation by the principal to distribute the same questionnaire online, a questionnaire using the Surveyshare.com^® portal was created, with the anticipation of receiving a greater number of responses. A total of 21 responses were recorded online. In total, 26 responses were collected, with a varied number of responses to the questions asked throughout the survey.

The low response rate demonstrated that the method of dissemination was limiting for the researcher, and it minimized the ability of the researcher to obtain sufficient responses to the survey. In addition, the number of participants and locations for the survey were too small to determine if there was any wide-ranging impact on any approaches that were taken regarding allergies in a larger number of schools. In future studies, it will be necessary to promote the study well in advance through flyers that are distributed to parents, as well as emails from the administrative team in order to attract greater attention to the survey. This process must begin well in advance of the study and provide sufficient information regarding its contents and purpose so that a greater number of parents will be interested in the study and what it has to offer to their students in terms of practical benefits.

Recommendations

Based upon the study framework and results, it is recommended that in future studies, an expanded study to include a larger number of study participants and schools be done in order to obtain more evidence regarding the prevalence of allergies within the student population and their impact on school performance. It is also recommended that some of the study questions should be modified to allow participants the ability to provide more concise responses regarding the prevalence of allergies in students. These modifications should include a larger number of questions that require specific replies that will identify areas of need and focus for students with allergies.

Conclusions

Based upon the study results, allergies had an impact on student performance in the form of limited focus and concentration for some students. The results also suggested allergies in the classroom setting required a higher level of attention and focus of the student to offset the impact they experienced due in part to allergy symptoms, with respect to their school performance. Armed with this information, the teachers and parents can discuss alternatives and to determine which course of action is appropriate in the future.

Master’s Degree Experience

Impact on practice. This experience has enabled me to recognize my own desire to earn a promotion, but to also realize that I might be excluded from promotional opportunities because I did not have a master’s degree. This was a difficult obstacle for me; therefore, I sought to overcome this issue by earning my degree and making the most of my career opportunities.

Impact on self. From a personal perspective, this study has provided much insight regarding my ability to complete a master’s degree program in my chosen field. I am continuously seeking new opportunities to expand my personal and professional growth and strive to be the best that I can be through these experiences. Prior to my admission to the University, I struggled to identify a program that could enable me to achieve a balance between my work life, my home life, and my academic career. Fortunately, this program has provided me with that balance and has had a significant impact on my life.

Future plans. My future plans include continued career advancement to the next level. This includes a possible promotion to Department Administrator in the coming months, along with other opportunities that may come my way with my master’s degree in hand. This degree will provide many advantages in my current and future career path.

References

Akinbami, L.J., Parker, J.D., & Merkle, S. (2010). Factors associated with school absence among children with symptomatic asthma, United States, 2002-2003. Pediatric Allergy, Immunology, and Pulmonology, 23(3), 191-200. doi:10.1089/ped.2010.0013

American Academy of Allergy Asthma & Immunology. (2014). Allergy statistics. Retrieved from  http://www.aaaai.org/about-the-aaaai/newsroom/allergy-statistics.aspx

American Academy of Pediatrics. (2012). Role of the school physician. Pediatrics, 131(1), 178-182. doi:10.1542/peds.2012-2995

American Academy of Pediatrics. (2014). What causes allergies? Retrieved from http://www.healthychildren.org/English/health-issues/conditions/allergies-asthma/pages/Allergy-Causes.aspx

Bener, A. (2011). The impact of asthma and allergic diseases on schoolchildren: Are they at increased risk of absenteeism and poor school performance? doi: 10.5772/18222

Blackman, J. A., & Gurka, M. J. (2007). Developmental and behavioral comorbidities of asthma in children. Journal of Developmental & Behavioral Pediatrics, 28(2), 92-99. doi:10.1097/01.DBP.0000267557.80834.e5

Briggs, D. (2003). Environmental pollution and the global burden of disease. British Medical Bulletin, 68(1), 1-24. doi:10.1093/bmb/ldg019

Brown, S.G., Mullin, R.J., & Gold, M.S. (2006). Anaphylaxis: Diagnosis and management. Medical Journal of Australia, 185(5), 283-289. Retrieved from https://www.mja.com.au/journal/2006/185/5/2-anaphylaxis-diagnosis-and-management

Burks, A.W., Jones, S.M., Boyce, J.A., Scherer, S.H., Wood, R.A., Assa’ad, A., & Sampson,  H.A. (2011). NIAID-sponsored 2010 guidelines for managing food allergy: Applications in the pediatric population. Pediatrics, 128(5), 955-965. doi: 10.1542/peds.2011-0539

Carlsen, KCL, Roll, S., Carlson, K.H., Mowinckel, P., Wijga, A.H., Brunekreef, B., …

Wickman, M. (2012). Does pet ownership in infancy lead to asthma or allergy at school age? Pooled analysis of individual participant data from 11 European birth cohorts. doi:10.1371/journal.pone.0043214

Centers for Disease Control. 2014). Trends in allergic conditions among children: United States, 1997-2011. Retrieved from http://www.cdc.gov/nchs/data/databriefs/db121.htm

Civelek, E., Yavuz, S.T., Boz, A.B., Orhan, F., Yuksel, H., Uner, A., Cakir, B., & Sekerel, B.E. (2010). Epidemiology and burden of rhinitis and rhinoconjunctivitis in 9- to 11-year old children. American Journal of Rhinology & Allergy, 24(5), 364-370. doi:10.2500/ajar.2010.24.3484

Cummings, A.J., Knibb, R.C., King, R.M., & Lucas, J.S. (2010). The psychosocial impact of food allergy and food hypersensitivity in children, adolescents and their families: A review. Allergy, 65(8), 933-945. doi: 10.1111/j.1398-9995.2010.02342.x

Engelke, M. K., Guttu, M., Warren, M. B., & Swanson, M. (2008). School nurse case management for children with chronic illness: Health, academic, and quality of life outcomes. The Journal of School Nursing, 24(4), 205-214. doi: 10.1177/1059840508319929

Felder-Puig, R., Baumgartner, M., Topf, R., Gadner, H., & Formann, A. K. (2008). Health- related quality of life in Austrian elementary school children. Medical care, 46(4), 432- 423 doi: 10.1097/MLR.0b013e3181648e95

Gentile, D., Bartholow, A., Valovirta, E., Scadding, G., & Skoner, D. (2013). Current and future directions in pediatric allergic rhinitis. The Journal of Allergy and Clinical Immunology: In Practice, 1(3), 214-226. doi: 10.1016/j.jaip.2013.03.012

Hamlet, H. S., Gergar, P. G., & Schaefer, B. A. (2011). Students living with chronic illness: The school counselor’s role. Professional School Counseling, 14(3), 202-210. doi: 10.5330/PSC.n.2011-14.202

Irwin, M.K., & Elam, M. (2011). Are we leaving children with chronic illness behind? Retrieved from http://files.eric.ed.gov/fulltext/EJ955447.pdf

Jáuregui, I., Mullol, J., Dávila, I., Ferrer, M., Bartra, J., Del Cuvillo, A., … Valero, A. (2009). Allergic rhinitis and school performance. J Investig Allergol Clin Immunol, 19(Suppl 1), 32-39. Retrieved from http://www.jiaci.org/issues/vol19s1/6.pdf

Lu, Y., Mak, K.K., van Bever, HPS, Ng, T.P., Mak, A., & Ho, RCM. (2012). Prevalence of anxiety and depressive symptoms in adolescents with asthma: A meta-analysis and meta-regression. Pediatric Allergy and Immunology, 23(8), 707-715. doi: 10.1111/pai.12000

Meijer, A. (2008). Chronic sleep reduction, functioning at school and school achievement in preadolescents. Journal of Sleep Research, 17(4), 395-405. doi:  10.1111/j.1365-2869.2008.00677.x

Mir, E., Panjabi, C., & Shah, A. (2012). Impact of allergic rhinitis on school going children.  Asia Pacific Allergy, 2(2), 93-100. doi: 10.5415/apallergy.2012.2.2.93

Moonie, S., Sterling, D. A., Figgs, L. W., & Castro, M. (2008). The relationship between school absence, academic performance, and asthma status. Journal of School Health, 78(3), 140- 148 doi: 10.1111/j.1746-1561.2007.00276.x

Muraro, A., Clark, A., Beyer, K., Borrego, L.M., Borres, M., Carlsen, KCL, … Zanchetti, M. (2010). The management of the allergic child at school: EAACI/GA Task Force on the allergic child at school. Allergy, 65(6), 681-689. doi: 10.1111/j.1398-9995.2010.02343.x

Pinquart, M., & Teubert, D. (2012). Academic, physical, and social functioning of children and adolescents with chronic physical illness: A meta-analysis. Journal of Pediatric Psychology, 37(4), 376-389. doi: 0.1093/jpepsy/jsr106

Russell, A.F., & Huber, M.M. (2013). Food allergy management in elementary school: Collaborating to maximize student safety. Journal of Asthma & Allergy, 4(6), 290-304. doi: 10.1177/2150129713486671

Skoner, D. (2001). Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis. Journal of Allergy and Clinical Immunology, 108(Suppl 1), 2-8. doi: 10.1067/mai.2001.115569

Stewart, M., Masuda, J.R., Letourneau, N., Anderson, S., & McGhan, S. (2011). “I want to meet other kids like me”: Support needs of children with asthma and allergies. Issues in Comprehensive Pediatric Nursing, 34(2), 62-78. doi: 10.3109/01460862.2011.572638

Taylor, R. M., Gibson, F., & Franck, L. S. (2008). A concept analysis of health?related quality of life in young people with chronic illness. Journal of clinical nursing, 17(14), 1823-1833. doi: 10.1111/j.1365-2702.2008.02379.x

Turner, P.J., & Kemp, A.S. (2012). Allergic rhinitis in children. Journal of Pediatrics and Child Health, 48, 302-310. doi: 10.1111/j.1440-1754.2010.01779.x