Volitional nonadherence is thought to be common among patients with chronic health conditions, including pediatric asthma. To date, no data have been published on the extent to which, and reasons why, families purposefully adjust their child's asthma regimen. This study provides descriptive data for parental report of volitional nonadherence in a sample of 101 children (ages 1-17 years) with asthma. Families tended to decrease rather than increase use of controller medication, but were more likely to increase rather than decrease preventive medication. Motivating factors for increasing medications centered around achieving better symptom control, whereas reasons for decreasing medications involved a perception of less need (ie, asthma was better) and desire to reduce treatment burden. Our results suggest it is important to better understand volitional nonadherence so that behavioral interventions aimed at promoting adherence and health outcome can be more effective.