Amagansett - With school about to begin, an allergist's office braces for the rush. It happens every year. Right after school begins, when kindergartners and first graders pull out their mats and rugs at quiet time, there is a spate of dust-induced asthma and rhinitis.

When leaves start falling, mold spores begin to increase both indoors and out. Fall and winter-time air-temperature inversions - warm air on top of cold - occur both inside and out. This decreases the vertical mixing of air, and contaminants build up as a result.

When building custodians fire up the furnaces, dust and mouse droppings that have accumulated all spring and summer are swept right out of the heating ducts, into the classroom.

Add to the normal everyday allergen-laden super-market of dust, dirt, chalk, pollen, pesticides, chemicals, sanitation supplies, perfumes, guinea pigs, mice, birds, rodents, and cockroaches - all make schools a 24-hour-a-day, year-round threat.

This year has been anecdotally cited as the "worst year ever" because of the length of the spring pollen season. While, allergists hear words like these every year, and I believe that changing weather patterns will ripple through the rest of the year, too.

It falls back on parents to do what's best for their kids. Here is a checklist for the start of the school year.

1. Find out who staffs the health clinic. Do they know how to administer a metered-dose inhaler or nebulizer treatment for your child? Do they have policies and procedures about food allergies, particularly peanuts? Do they regulate snacks and special-occasion treats such as birthday cupcakes?

2. Find out if school policy allows students to carry medication. If your child is old enough, make sure she knows how to use it properly. If students aren't permitted to carry medication, make sure the school staff knows where the medication is stored and how to administer it properly.

3. Let the school know how to reach you during the day in case of an emergency.

4. Tour your child's classroom before school starts to identify potential allergy and asthma triggers. Offer suggestions to protect your child's health.

5. If your child has exercise-induced asthma, talk to the school and staff responsible and make sure coaches and physical education teachers know the warning signs that your child is likely to experience and how to handle an emergency if one occurs.

6. Work with your child's teacher. When a child is itchy or having trouble breathing, it's hard to concentrate; certain over-the-counter and prescription medicines can make them moody and impact their ability to learn. Work with your child's teacher to develop ways to help your child focus.

7. Keep lines of communication with the school open throughout the year. Review your management plan periodically and make sure everyone is comfortable with the strategies in place.

8. Monitor your child's sleep carefully. If wheezing, coughing and sneezing are interrupting it because allergies and asthma are uncontrolled, there will be repercussions for school performance and general quality of life.

If your child is athletic and has asthma there are a few extra precautions you can take. Have your child run a few laps in a warm gym before going outside. This helps avoid cold air shock which causes bronchospasm. You might also ask your doctor about a medicine called a beta-agonist spray twenty minutes before exercise. There is no need to worry about exercising. Elite athletes who have overcome asthma to become champions, include soccer player David Beckham, Olympic Gold Medal skater Kristy Yamaguchi and Olympic swimmer Mark Spitz.

The bottom line? The most important thing that parents can do if they need help is to see an allergy specialist. Get a referral or get an appointment, do whatever it takes. Seeing a specialist is to best way to make sure your child gets the best and most effective treatment.