We use a different  method,  called ‘Steps’, to help  children understand the  process  of improving  their  carbon  dioxide levels, simply because  children  may  have  difficulty  using Exercise One.  More  detailed  information on  helping  children is contained  in Chapter Nine.

Steps is  also  helpful  as  a  measurement  of  progress, particularly if the child has difficulty in applying the control pause  correctly.  Steps involves  moving   the   muscles   to increase   the   carbon   dioxide   level,  and   this   is   then combined  with  the  child  holding  the breath,  which  will help to retain it.



For the purposes  explaining this exercise, let’s imagine again  that  you’re  dealing  with  a  child  called  Emily. To perform Steps Emily should:

✦   Take a small breath in for two seconds and a small breath out lasting three seconds.

✦   Hold her breath by pinching her nose. It’s better if Emily holds her nose by raising her hand  above her mouth  so that her mouth is visible. This way, if she takes a breath in through her mouth, it will be noticed.

✦   Get her to walk as many steps as she can until she needs to  breathe  in  again.  During  Steps, encourage  Emily to build  up  a large  air  shortage  by doing  as  many  steps as she  can  manage  before  she  breathes  in. Ensure  she doesn’t overdo it. If she does, it could become too stress- ful for her, and could put her off the exercises altogether.

✦   Encourage Emily to walk as many steps as possible, count aloud  every five  or  ten  steps,  again  ensuring  that  she doesn’t overdo it.

✦   When Emily starts breathing, it must be only through  her nose and her breathing  must be calmed immediately.  If her shoulders  rise or become tense, point this out to her, and  ask  her  to  let  her  shoulders  drop  to  the  normal resting position.

✦   After completing   Steps the  first  breath  will usually  be bigger  than  normal.  Make  sure  Emily reduces  or  sup- presses the second and third breaths.

✦   Get her to relax, by explaining that a relaxed body is like jelly on  a  plate,  so  that  there  is  no  tension   and  the muscles go all floppy. The more Emily relaxes, the quicker will be her recovery of normal breathing.

✦   Count each step aloud and record the number.  Compare each day’s steps with the previous day’s so that progress can be measured.


Measurement tool

If a child is unable  to do the  control  pause  correctly, the Steps exercise – the  best way of increasing  carbon  dioxide levels – can be used as a measurement tool. Always encourage the child to increase  their  steps over time. The goal is for the  child to be able to walk a hundred  paces without having  to take a breath.  Steps should  be done  only while walking. Reasonably fast walking is fine, but the child should not run.

If the child feels a relatively strong need to inhale following completion  of Steps, then  the exercises are being done correctly. If the child seems to be getting  stressed just get her to reduce the number  of steps she is taking so that it is not stressful for her.

Make sure to calm the deep breath sometimes  taken on completion  of the exercise. The Steps exercise is interspersed with reduced breathing  called ‘mouse breathing’ and details are contained  in the special chapter for children. Two to three sets of Steps should be practised each day, depending on the severity of the asthma  condition, and the more  severe the  condition  the  greater  the  number  of sets should be completed each day. If the child has severe asthma however, then do make sure that she doesn’t overdo it. Mind you, this  applies equally to adults! Don’t push  a child  too hard.  Breathing   exercises  are  not  meant   to  be  stressful, because increased stress is completely counter-productive; it will cause  increased  breathing,  and  the  child  may  not  be willing to continue with the exercises. Again, the best times  for the Steps exercises are before breakfast in the morning and at night, just before going to bed.





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