New Research: Mobile Pediatric Asthma Screening Tool Connects More Kids with Respiratory Care.

New data from MedStar Health, presented at the American Academy of Pediatrics 2025 National Conference and Exhibition, show that routine screening for asthma and environmental triggers in high-prevalence populations can diagnose asthma earlier and provide a more holistic approach to care.

Across the wards of Washington, D.C., the prevalence of childhood asthma hovers between 9% and nearly 18%—peaking at more than double the national rate of 7%.

Current well-child visit guidelines do not include specific screening recommendations for asthma or in-home triggers; these visits are often short and packed with other tests and health discussions. Asthma symptoms can overlap with common childhood ailments, and parents may not discuss these symptoms with their pediatrician. The child may also be treated at urgent care or ERs for asthma symptoms, but without a complete history, may not get an asthma diagnosis. This can lead to the known problem of underdiagnosis or late diagnosis and can contribute to missed school days and participation in activities, increased ER and urgent care visits, and short-term and long-term lung complications.

But new data from MedStar Health shows that routine asthma screening is not only possible, but also practical when delivered in an accessible way.

We presented data from our study, “Screening for Asthma and Related Environmental Risks in a High-Risk Pediatric Populations: A Descriptive Analysis of Universal Screening,” at the American Academy of Pediatrics annual meeting in September 2025. Read the press release about this study.

We decided to screen at all well-child checks for asthma symptoms such as nighttime cough, exercise intolerance, or past use of an inhaler, and to screen for associated environmental risks in the home, such as mold, rodents, and roaches, which are common asthma triggers.

Having uncontrolled asthma in childhood significantly increases the risk of hospitalization for lung-related illness and having lung diseases as an adult. Every year, asthma symptoms cause thousands of emergency department visits and millions of days of missed work and school.

Suppose we can identify children who have undiagnosed asthma or are at risk for it. In that case, we can intervene—alongside our community partners—to manage asthma symptoms, help families reduce environmental triggers at home, and potentially reduce the long-term health and financial burdens of uncontrolled asthma.

Screening methods that yield results.

This retrospective cohort study included 650 children aged two and older who live in a high-prevalence area for asthma diagnoses. With each family, we completed our universal Asthma Risk and Control Screen (ARCS), a tool we designed to help identify asthma symptoms such as exercise intolerance and coughing or breathing problems at night.

We also screened for poor housing quality that can trigger asthma, such as rodents, mold, and roaches. We found that 18% of children had a previous diagnosis of asthma, and of those that didn’t, 212 screened positive on the ARCS. Of those, 51 went on to have a diagnosis of asthma, which would have been delayed if not for the screening 34% of patients reported poor housing quality. Almost half of those children screened positive for ARCS.

Bringing comprehensive, holistic care to the community.

MedStar Health has operated the Kids Medical Mobile Clinic for more than 30 years, bringing pediatric services to families facing socioeconomic barriers to health care. Through the generous support of Monumental Sports & Entertainment, our pediatricians see an average of 800 young patients per year in our two mobile units. Patients range in age from newborns to 24 years old. Read about the 2024 upgrades to the mobile units.

We can spend more time with families in the mobile units than in a typical clinic setting—visits typically last 45 minutes per family. In that time, we can discuss a range of topics, from the ARCS screener to mental health needs, nutrition, educational and developmental needs, family health history, social and financial health needs, and environmental exposures that impact overall health, such as pet dander, secondhand smoke, mold, and pests like cockroaches.

If a child screens positive on the ARCS screening, the pediatric provider completes a more extensive history. Extended conversations help our mobile care providers connect symptoms and scenarios that can appear unrelated when evaluated in isolation. For example, children with undiagnosed asthma often end up in urgent care or the emergency department with symptoms that could easily be attributed to a non-asthma illness. Some of these include:

• Wheezing with respiratory illnesses
• Exercise intolerance (outsized breathing effort with activity)
• Nighttime coughing or shortness of breath
• Prolonged coughing after a respiratory illness
• History of using an inhaler prescribed at an urgent care, ED, or borrowed from a family member

Children with these symptoms who also have other signs of atopy (allergic conditions) like eczema or food allergies, and/or have a family member with asthma, are more likely to have asthma themselves.

Our approach has been successful in identifying previously undiagnosed children with asthma, enabling them to receive appropriate treatment earlier. This can decrease missed school days, improve participation in sports and play, and reduce ER visits, hospitalizations, and short- and long-term lung complications.

Our holistic medical model is enhanced through partnerships with the Yachad Healthy Homes program, a clinical organizations that provide families with free home assessments and asthma-trigger remediation, such as air filters, mattress covers, pest control, and mold management, as well as the Georgetown University Health Justice Alliance to provide support in navigating concerns about tenants’ rights to live in healthy housing. Our teams meet monthly to discuss ways to improve our collective services for families and to advance advocacy for populations at high risk of asthma.

The results of this study have given us confidence to continue this model of early screening and a holistic approach to asthma care. We hope the asthma screening approach we’ve designed will be replicated in other high-prevalence communities across the U.S. to validate the tool. Our goal is to help improve national pediatric asthma outcomes, decrease disparities, and inform new guidelines for early diagnosis and treatment so more kids can grow up healthy and thriving.