"I've always liked basketball," said fourteen year old Daniel Henry as he shot hoops in his backyard near Burien.
But last school year was a tough one for his sports.
"You really want to be out there enjoying life but you can't because you're stuck in the hospital," he said.
It was because of his asthma, that flared more than once.
"We ended up at the emergency room at least once a month this last fall," said Daniel's mother Chantille Henry.
Daniel has a rescue inhaler and allergy medicines to ease symptoms. But right now he uses another medicine to keep chronic asthma under control, a combination drug that contains a corticosteroid.
"Half of children who should be on controller medication are. So half of them aren't," said Seattle Children's pediatrician Dr. Dimitri Christakis.
The controllers reduce lung inflammation that causes asthma flare-ups said Dr. Christakis. He's Director of the Center for Child Health Behavior and Development at Seattle Children's Research Institute.
"Parents and for that matter pediatricians don't frequently know which children should be on controller medications," he said.
So how do you know if your child might need them? Dr. Christakis said even mild asthma symptoms, two or three times a week should prompt a trip to the doctor. Still, many parents opt to keep their child off a daily medicine.
"Every medication has potential risks. And the controller medications that we use are what's called an inhaled steroid. And that's part of what freaks parents out because they hear the word steroid," Dr. Christakis said.
The steroids have been shown to be safe and effective in children. They're not the same as anabolic steroids abused by some athletes. Daniel's mom sees a trade off. When his asthma gets out of control, he needs a much more powerful steroid.
"I think this last year with his emergency room visits he probably was on it three or four times this last fall, which is a lot," said Chantille Henry.
There's another reasons some kids may not get the controller medicine. Those medications can be costly, even if families have insurance.
But the Henry family believes the price of not using controller medicine is far too high.
"It's much better to have the hassle of taking them than getting behind and feeling sick," said Daniel's mother.