A child experiencing a severe asthma attack is likely to demonstrate which of the following symptoms?

A child experiencing a severe asthma attack often exhibits difficulty lying flat due to respiratory distress. This symptom arises from the increased work of breathing and the heightened effort required to obtain sufficient airflow, leading to a preference for sitting or leaning forward in order to optimize respiratory mechanics. The need for accessory muscle use and the position the child assumes can provide temporary relief from the feeling of breathlessness.

While silent chest with no audible wheezing can occur in severe cases, it typically indicates a very compromised respiratory status where airflow is greatly reduced, potentially leading to respiratory failure. Severe accessory muscle use is also common during a severe asthma attack, but the most distinctive symptom that indicates acute distress and difficulty maintaining adequate ventilation is the child's positioning. Frequent cough with yellow sputum is more characteristic of an infection rather than the acute presentation of asthma, as asthma-related cough is usually dry or associated with bronchial hyperreactivity rather than productive. Thus, the most telling symptom in this context is the child's observable difficulty in lying flat, reflecting significant respiratory struggle.