More than 200 children and parents gathered Saturday for a pep rally of sorts, but this seminar was dedicated to helping them live with a debilitating and frightening disease that is often misunderstood: asthma.

Asthma is a disease that afflicts more than 10 million Americans. A recent estimate by the National Center for Health Statistics holds that about 23,400 children ages 5 to 14 in Maryland have asthma. One quarter of school absenteeism nationwide can be attributed to asthma.

The program, introduced by Dr. Stanley Wolf of The Allergy Center, featured a puppet show and a talk by 1984 Olympic Gold Medalist swimmer Nancy Hogshead, an asthmatic who explained to the children and parents that even intense physical activities are possible when the disease is controlled.

Asthma, although it can be triggered by stress, is first and foremost a disease of the body, according to Wolf. It is characterized by 60 percent reduction of lung capacity even during periods when the asthmatic is free from an attack. An asthmatic child also has lung tissues that are far more sensitive to certain irritants than normal lungs, leading to allergic reactions with results ranging fom mild coughs to extreme difficulty breathing, especially exhaling.

During an asthma attack, three things happen. Muscles around breathing tubes from the large bronchus to the tiny bronchioles contract, narrowing the passage space in the lungs for air. Further decreasing this narrowed channel, the tissues of the breathing walls swell up.

There is also a tremendous increase in mucus secretion from the clogged tubes, further blocking the flow of air and causing wheezing, a mucus vibration.

The most common treatments for asthma include avoidance of irritants, allergy shots to build tolerance, and use of an inhaler commonly associated with the disease, and a variety of bronchodilator drugs.

Wolf said that although avoiding all triggers is not possible, many households can be made into more tolerable environments for the asthmatic. "You wouldn't believe how hard it is to get a cat out of a house," he said.

Because asthmatic episodes can be set off suddenly by such a wide variety of irritants -- common allergens including tobacco smoke, mold, pet dander, pollen and smoke, and nonallergenic triggers such as cold air, excitement and stress -- parents of asthmatic children are continually on the alert for the telltale wheezing and coughing that signal the onset of an attack.

"Sometimes when you have asthma you have to get Mom and Dad to breathe easier, too," Scott, the asthmatic puppet, said to the audience, eliciting giggles from children and both sighs and smiles of recognition from their parents.

Josh Goldstein, 6, said he has missed a week and a half of school this year, yet he swims regularly. He said he was especially impressed by Hogshead, who stresed deep breathing, use of the inhaler and proper warmup.

Whitney Tredwell, 11, said she is determined to live a normal life despite her disease. She plays soccer and said that as long as she has her inhaler and does not run too long, she is fine.