Future directions of research on respiratory disorders
Context is everything Jonathan Letham, Motherless Brooklyn, 1999
A few decades ago, behavioral scientists were included as members of multidisciplinarian teams working with respiratory disorders, particularly pediatric asthma (Renne & Creer, 1985). At two dozen or so residential treatment centers for the disorder in the United States, behavioral scientists attempted to help patients cope with asthma and the problems it spawned. There were few effective medical treatments for the condition; in addition, a number of treatment-related problems were prominent. Perhaps the biggest single problem involved the consequences arising from a reliance on oral corticosteroids for severe asthma. The only way to manage asthma in many children was through a regimen of up to 90 mg of prednisone, a commonly prescribed oral corticosteroid taken on an alternate-day basis. The price of control was steep: the children often experienced a stunting of growth, pufﬁness of the face, delayed menses, brittle bones, and unwanted facial hair. Even so, it was not uncommon for corticosteroids to fail in controlling a child’s asthma.