How decide when to use a controller med ongoing for 8 year old with asthma (use singulair (montelukast) during spring pollen season, but coughing more other times)?

Persistent asthma: At age 5-11 controller meds usually help persistent asthma, defined as 1) symptoms >2x/wk, 2) wake at night 3 or more times/mo, 3) use inhaler for symptoms >2x/wk, 4) asthma limits activities, or 5) needed oral steroids 2x in last year. There may be other reasons to start too, such as asthma getting worse fast.

Use albuterol often?: There are several ways to decide when to use controller (preventive) meds. A patient can add a preventive med if he's needing albuterol (or xopenex) more than twice a week. Then, he can add a 2nd or 3rd preventive med if he still needs albuterol >2x/wk when already on one preventive med. He can wean off one preventive med at a time as he improves, but add the med back if symptoms increase again.