Background: Dysfunctional breathing (DB) is commonly recognised in adults but prevalence within CYP remains unclear. Distinguishing it from other conditions (e.g. asthma) is difficult in the absence of agreed definition and criteria. Diagnosis occurs following exclusion of other causes with symptoms and outcome measures based on adult data. Obtaining an understanding of which criteria experienced clinicians consider most useful may reduce misdiagnosis and improve treatment.

Objective:To gain a better understanding of the presentation of dysfunctional breathing, specific to CYP.

Methods: An e-Delphi survey was conducted with paediatric respiratory experts across the UK: medical, nursing & physiotherapy with >5 yrs experience. A structured questionnaire was used to identify relative importance of main clinical features and descriptions to reach an agreement on the definition of this combination of symptoms. Consensus was defined in advance at 75% over 3 rounds.

Results: ?Dysfunctional breathing? remains the most commonly used term inter-professionally as an over-arching term, encompassing breathing pattern disorder, inducible laryngeal obstruction & vocal cord dysfunction although other terms may be used with patients. Agreed key clinical features are breathlessness, chest/throat tightness, difficulty breathing in and a sensation of air hunger. CYP most commonly describe ineffective inhalers, breathlessness in excess of demand and ability to return to activity after brief rest.

Conclusion: A multidisciplinary Delphi panel has delivered a high level of agreement on the presentation & clinical features of DB in CYP. This will increase recognition and treatment of the condition.