The differential diagnosis of the child with wheezing can be approached on an age group basis. Infants are at a higher risk for congenital abnormalities and most infectious conditions. Aspiration of a foreign body and cystic fibrosis may occur most commonly early in life but can be seen in any age. GER with pulmonary involvement may occur at any age but more common in smaller children. Vocal cord dysfunction and the hyperventilation syndrome merit consideration mainly in the adolescent age group.

The investigations to be considered are chest xrays, sinus xrays, lung function tests, bronchial challenge tests, mantoux test, sweat test, immune function studies, ciliary studies and reflux studies. Along with these studies response to bronchodilator therapy should also be assessed. If response is good and other tests are negative then consider asthma alone or in association with other diseases.