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The Informed Parent

Revealing the Choking Game

by Shanna R. Cox, M.D., F.A.A.P.
Published on Dec. 18, 2006

The Choking Game is truly not a game at all. It is a process where oxygen and/or blood flow is restricted to the brain creating a transient high feeling. The high is the result of cell asphyxia and subsequent re-oxygenation once the pressure is released that was restricting the oxygen and blood flow. The pressure may be applied by one person choking another person, or artificially by anything that can be used as a ligature, such as a belt, rope, or bed sheet. This practice or "game" as many children refer to it may lead to accidental death by strangulation, brain damage, seizure, stroke and retinal hemorrhage. This is not the stuff of movies but of our nation's schools, camps, and playgrounds.

Statistics show the choking game is popular among approximately nine-to-fourteen-year-old children who may have no other seemingly high risk behaviors. The action may be undertaken in groups where children watch and interact with each other in an altered state of consciousness, or may be performed alone. The game has many other names including:

  • Space Monkey
  • Space Cowboy
  • Suffocation Game
  • Gasp
  • Flat liner
  • Sleeper Hold
  • Black Out of Black Hole
  • Airplaning
  • Natural High
  • Purple Dragon/Monkey
  • Hanging Game
  • Cloud Nine

Many parents who have spoken out about their child's accidental asphyxia had no prior knowledge that their child was engaging in this type of activity, or that it existed. Advocacy groups stress that this practice is something parents and health care providers must be alert to, just as they would be to any high risk behavior.

Unfortunately there may be few telltale signs to this activity. Parents can be aware of the use of any of the above terms or questions regarding "losing consciousness or passing out." Requests for a belt or rope should be investigated and taken seriously as should any strange findings of these or other like items around a bedpost or closet hook. Unexplained bruises, concussions, or personality changes should prompt further investigation and discussion among the family. Bloodshot eyes may also be a red flag. Many of these items are non-specific, but as with many issues with children they may open a discussion that leads to an unexpected result.

It is important to note that this game may run between groups or even within families. Therefore, it is essential that if any individual close to your child should be discovered as participating in this practice that your supervision of your own child must be heightened. This is an alarming problem that has been under the radar screen for many parents and practitioners. It should be considered carefully by all those in the care of children.

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