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Dyspnea, or breathlessness, is used to characterize a subjective experience of breathing discomfort that is composed of qualitatively distinct sensations that vary in intensity. 1 It is a common symptom in patients with respiratory and cardiovascular diseases, and a cause of morbidity in the elderly. 2 Dyspnea varies along several dimensions, including intensity and salience, and can include cognitive and emotional components. 3 As such, it is a complex sensory experience, derived from physiologic conditions that both infl uence and are infl uenced by psychologic processes and social variables. [1][2][3][4] The terms used to describe dyspnea have been developed and studied extensively in both laboratory and clinical settings. 5-9 These studies have included: asking adults to select items from standardized questionnaires; identifying, by cluster analysis, descriptor groupings (clusters) that are independent of one another; and relating clusters with physiologic elements of disease. The work has shown that descriptor clusters are fairly consistent among patients with a disease but vary between patients with different disorders. Patients with asthma, for example, are likely to endorse the questionnaire items "My chest feels tight" Background: In adult patients, the consistent use of language to describe dyspnea enhances patient-provider communication and contributes to diagnostic and therapeutic decisions. The objective of this research was to determine whether pediatric patients similarly display consistency in the language used to describe "uncomfortable awareness of breathing." Methods: One hundred children between the ages of 8 and 15 years with moderate to severe persistent asthma enrolled in an asthma education research program completed questionnaires regarding descriptors of asthma on each of two occasions. In addition to the breathlessness questionnaires, demographic information, self-reported asthma severity, ED visits, missed school days, anthropometrics, and spirometry were obtained for each participant. Results: Children were reliable in their choice of the descriptors that they applied to their breathing discomfort across two occasions, and they selected the same descriptors that were used by adults with asthma in previous studies. Children with greater self-reported asthma severity endorsed more descriptors to characterize breathing discomfort than did children with less severe asthma, but no differences were found among children based on demographic or anthropometric variables. Conclusions: Children with moderate to severe persistent asthma are reliable in their choice of descriptors of breathlessness. Knowledge of their experience of symptoms may be helpful clinically in the assessment and management of asthma.