Most parents know nothing about it. School officials who do usually don't share their knowledge. And when it leads to tragedy, police often are clueless why or how it happened.
The choking game is America's dirty little secret gasping for public exposure. And Chatham College graduate students are ready to provide it.
Angela Mills, a 24-year-old graduate student in Chatham College's Counseling Psychology Program and School Counseling Certification, said she was surprised when she asked 10 students, ages 6 to 12, if they'd heard of the choking game.
"To my surprise, nine out of 10 of them heard of it, knew of it, played it or had friends who tried it," she said.
The game goes by various names including the pass-out game, fainting game, suffocation roulette, flat-line game, purple dragon and black hole.
Under guidance from Mark Lepore, Chatham assistant professor of counseling psychology and school counseling certification, a team of his graduate students decided to drag the secret out of the shadows and expose it for what it is: Breathless tragedy waiting to happen.
Chatham research reveals that 1,800 people have died in the process of seeking a high by restricting oxygen and blood flow to the brain via asphyxiation.
After extensive research, the group now offers its findings to educators, administrators and students as a way of reducing the number of choking-game victims.
"We know that kids are getting information from their peers in social situations and are not getting the negative side," Dr. Lepore said. "We believe they should be given the dangerous side and the harmful effects it causes."
The Chatham presentation explains the game: Asphyxiation generates an adrenaline rush and high sensation, described as a "tingly or floaty" feeling. When the child falls unconscious, pressure is released and a "secondary high" is achieved.
But this is no game, the group warns. The practice can lead to chronic injury and death. Often unwitting police rule that victims committed suicide.
Communities often learn about the choking game only after a death occurs. That happened earlier this year when a Mt. Lebanon boy -- an eighth-grader in Jefferson Middle School -- died. He's believed to be the first documented choking-game victim in Allegheny County.
"We want to take it out of the shadows and bring it to the forefront," said Chatham graduate student Sarah Kohlman, 23, of Pittsburgh, noting their focus is prevention.
Results of the game often are more than a youngster bargains for. If it doesn't kill, it can cause brain damage and heart attacks. It also can lead to excruciating headaches, loss of concentration, a flushed face, bloodshot eyes or other noticeable eye stress, cognitive defects, neuro-muscular problems, slurred speech and changes in personality that include agitation and aggression, the group said.
Chatham researchers recommend that parents and teachers look for warning signs -- suspicious marks on the child's neck that can prompt students to wear turtleneck sweaters, scarves or turned-up collars.
Other clues include straps, belts or ropes lying near the child without reason. Thuds heard in a bedroom or against the wall and a child's demand for privacy in a locked bedroom also can foretell problems.
For youngsters, the appeal is experiencing high or erotic sensations without spending money, using drugs or breaking the law. People have been playing the tragic game for generations, the researchers said.
"In almost any group of adults, one can find someone who played this game in some form or another when they were children," the group says in its presentation.
The most dangerous situation occurs when children are alone and use ropes or straps to cut off breathing.
"Make no mistake: It is never safe, but most of the children who get into trouble are alone," their printout states.
"It's a game that's not geared to a certain group. Rich people, poor people and people of different statuses do it," said Lisa Musgrave, a Chatham graduate student from West Mifflin. "It's not just bad kids. All kids are at risk."
Dr. Lepore said his students chose to delve into the choking game during his Contemporary Issues, Crisis and Addiction class. Research started with the Internet and included visits to memorial sites of choking-game victims. Their research "snowballed from there," Ms. Mills said.
It persuaded Dr. Lepore that they should take their information beyond classroom walls.
In October, Chatham students presented their research at the Countywide Professional Development Day held at Quaker Valley High School and later at a Butler County Counselors Association conference.
Anyone interested in scheduling a presentation should call Dr. Lepore at 412-365-2782.
"If one kid is helped by our presentation, it's worth it," Ms. Musgrave said.Andy Starnes, Post-Gazette
Dr. Mark Lepore, assistant professor of counseling psychology at Chatham College, at center, front, and his graduate students, at rear, from left, Lisa Musgrave, Brian Coder and Angela Mills have put together a program and research into the sometimes fatal choking game.
Click photo for larger image.
David Templeton can be reached at firstname.lastname@example.org or 412-263-1578.