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By Any Name, This Game Is Deadly

Do your kids play something called "space monkey"? Or maybe "the scarf game"? Maybe they sound like fun. What they are, though, are choking games -- where kids choke themselves or their friends to elicit a brief sensation of euphoria. Apparently many adolescents, including lots of high-achievers, view them as a safer alternative to using drugs and alcohol. But they're not safer.

An editorial in the January issue of the Archives of Pediatric and Adolescent Medicine suggests that one measure we might take to stop this dangerous behavior is to stop calling it a game.

The authors, Kenneth Katz and Robin Toblin, both epidemic intelligence service officers with the U.S. Centers for Disease Control and Prevention (CDC), suggest that physicians, parents and members of the media start referring to choking games as "strangulation activity."

Toblin helped write the widely publicized report in the CDC's Morbidity and Mortality Weekly Report last February, the first to document the increasing incidence of death related to this pastime. In that report, researchers alerted parents to telltale signs of a young person's participation: bloodshot eyes, frequent and severe headaches, disorientation after spending time alone and suspicious marks on the neck.

Toblin says the idea for the name switch came up when she first presented data from that study to a group of physicians. One of the doctors was Katz, who suggested that a more ominous name might drive home the point that it's serious business. Katz and Toblin reason that, just as calling motor vehicle accidents "crashes" suggests that they are potentially preventable and thus allows for taking steps to prevent such events, so might calling the choking game "strangulation" allow for a different, more effective set of interventions.

Plus, Toblin observes, "The name 'the choking game' is a media phenomenon in general. Kids were calling it "blackout' or 'pass out.' If we can get the media to adopt [the new name], at least that term will be floating around" and might influence the thinking of some number of young people. Toblin notes that an online survey posted on the Web site of the DB Foundation, devoted to disseminating information about the choking game, as to whether to change the activity's name drew "mixed opinions."

No matter what we well-meaning grownups choose to call it, my gut feeling is that kids are going to call it what they will -- the more clever the title, the better -- and that, until we can figure out how to stop them, they're going to keep doing it.

My sentiment's shared by Sharron Grant, executive director of the organization GASP -- for Games Adolescents Shouldn't Play -- which, like the DB Foundation, works to raise awareness and educate students and adults about the choking game.

Grant, who lost her 12-year-old son to self-choking in 2003, says GASP frequently receives mail asking the organization to stop referring to "the choking game." But Grant, who says she agrees in principle ("I hate the name of it," she says), maintains that "It's not us calling it a game, it's the kids. If you call it any other thing, you're not facing the fact that they know about it -- and they'll just say, 'That's not what we're doing.'"

"When we change the name," Grant asks, "are we going to reach anyone out there but doctors and parents?"

Of course, reaching parents is a good place to start. It was perhaps not surprising that most of the parents whose kids' deaths were documented in the February report had never heard of the choking game until tragedy occurred. But nearly a year later, despite the publicity, we adults persist in having no clue. Last month, a 17-year-old Alaska girl accidentally strangled herself while playing the choking game alone; her parents reportedly said they'd never heard of the game until it took their daughter's life. And in Canada, also last month, a 16-year-old boy was found dead: here's the newspaper's quote from a "veteran coroner":

"I have heard ... the family has apparently said that he was involved in a 'choking game,'" said veteran coroner Dr. Hans Westenberg of Kingston. "I've never heard of such a game, so I'm not sure what exactly they're talking about."

If you want to drill the serious nature of that "game" into your own head -- or your kid's -- take a few minutes to watch GASP's heartbreaking video, which begins with a recording of a 13-year-old boy's emergency call upon finding the lifeless body of his twin brother, who had choked himself while his mother was in the next room.

We all know our kids have no clue as to their own mortality. And we know that adolescents are bound to take stupid risks; it's in their job description. Well, a parent's job description includes the unpleasant and unsettling task of talking to our kids about stupid risks. I did so last year, after the CDC report was published. I was treated to the royal eye-rolling treatment and the comment, "Jeez, Mom, do you think we're STUPID?"

Well, yes, I have to assume they're just about as stupid as I was when I was their age. And I'm going to talk with them again tonight -- just like I talked with them a few weeks ago after I read about smart, accomplished teenagers overdosing on heroin. I don't care how much they roll their eyes.

And when I finish talking to the kids, I'm going to use some of the time I usually reserve for crafting pithy remarks on Facebook to send information about the choking game, or strangulation activity, to my friends who have teenage kids.

This evening, ask your kids about the choking game. Then please let us know what you learn.

By Jennifer LaRue Huget  |  January 7, 2009; 7:00 AM ET
Categories:  Family Health  
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In a country of 300 million with (let's just estimate this) approximately 30-40 million teenagers, how serious do you REALLY think this problem is? I mean, how many teenagers have EVER engaged in this activity, let alone died from it? Now, do the math and tell me what percentage we're talking about. I think you'll find the incidence rate extremely low and realize that other "safe" activities such as skiing are far more prevalent and also produce far more harm to teenagers. I've asked around and can't find anyone who even KNOWS of anyone who has ever played this game.

My problem with articles like this and particularly editorials like the one described above is that they sensationalize issues, turning extremely rare things into the latest boogeymen for parents to fear in their children.

Posted by: rlalumiere | January 7, 2009 4:24 PM | Report abuse

This is not so rare. I know two people who died of self-strangulation, both in situations that were clearly not suicides. It is not a boogeyman. It is real and it is tragic when it goes wrong.

Posted by: Judy9 | January 7, 2009 10:27 PM | Report abuse

Two representative studies in Ontario and Oregon show that 6-7% of youth have tried this activity. In Ontario alone, the findings suggested that this meant that 79,000 youth had engaged in the activity.

Posted by: toblin | January 8, 2009 9:38 AM | Report abuse

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