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    Is Your Child Playing the 'Choking Game'?

    Survey Finds 6% of Oregon 8th-Graders Have Tried the Potentially Deadly Activity

    Getting the Word Out

    "The public health challenge right now is getting awareness and education to adults and [health care] providers," Nystrom says. A 2009 report noted that up to a third of pediatricians had never heard of the choking game, he says.

    "Those that had [heard of it] had limited ability to identify signs and symptoms." Assessing young patients' risk of dangerous behaviors such as the choking game needs to be a part of teen doctor visits, Nystrom says.

    Some children who engage in the behavior might be overlooked because of myths surrounding it, he says. One common belief is that boys are much more likely to play the choking game than girls, but his study found the sexes were pretty even.

    Nystrom's team also found that sexual activity and substance use were significantly associated with choking game participation for boys and girls.

    Thomas Andrew, MD, New Hampshire's chief medical examiner, called Nystrom's study "very important," because "it gives us a better handle" on how many young people engage in the choking game.

    "Now," Andrew says, "the question still before us is whether or not there are ways to identify that potential six percent" before they try it. Those teens could then be the focus of prevention strategies effective against high-risk behaviors, he says.

    Instead of treating the choking game like some forbidden fruit, increasing its appeal, adults need to emphasize its health dangers, Andrew says.

    "The thing I would say first for parents is don't be afraid to talk to your kids, and definitely listen to them," Nystrom says. Watch for warning signs, he says, such as talk about the game, attempts to hide marks on the neck, or ropes and the like tied on doorknobs.

    Sharon Grant says her son, Jesse, told her he learned the choking game at summer camp and viewed it as just another type of camp hijinks, like short-sheeting a bunkmate's bed. She recognized it as dangerous but says she wasn't worried about her son because he was an "A" student and an athlete. It wasn't until three months after Jesse's death, Grant says, that she learned he had taught his younger brother how to play the game.

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