Pilot trial of 80 severe asthmatics attending the HRCC that includes 24/7 cell phone access to skilled primary caregivers or to HRCC with the addition of HCCC that will also include: 1) monitoring and augmenting treatment adherence using a special sensor to track inhaler use and identify inadequate or excessive medication; 2) using a simple hand-held PIKO-1 device to assess and transmit to caregivers the 1-second forced expiratory volume, allowing caregivers to better assist the parents and to make better treatment decisions and gauge response at any hour.