‘Choking Game’ Yields Varying Responses From Educators

Reneé Mills knew something was happening to her bright, blue-eyed, 13-year-old son, Dakota, in the weeks before he died.

Too often, she said, the school nurse called home to say the 7th grader, known as Coty, was complaining about headaches. His temper was short. A former school nurse herself, Ms. Mills wondered whether her son was playing tricks on staff members at Lunenburg Middle School, located in this rural community a little more than an hour southwest of Richmond, Va. But worried, she asked a family friend a few years older than Coty to gently probe to see whether her son might be using drugs.

On March 29, Coty Mills was found dead in his bedroom closet, with a device made of two belts wrapped around his neck.

Ms. Mills now believes her son’s headaches, glazed eyes, and aggressiveness were indications that he was playing the “choking game,” a practice in which people briefly cut off the flow of air and blood to their brains because of the temporary “rush” or euphoria they feel when oxygen and blood flow is restored.

Such asphyxial activities are not new, but a spate of deaths like Coty’s among young people around the country in the past year has brought further media attention to the subject and turned parents like Ms. Mills into advocates for greater awareness of the dangers involved.

But the subject is a sensitive one for schools. Some administrators have actively enlisted in efforts to inform students and parents about the risks of practices like the choking game, while other educators say they’re worried that publicizing the subject among students risks inspiring copycat behavior.

“School districts in my neck of the woods say, ‘Don’t tell them, or they’ll do it,’ which to my belief is absurd,” said Dr. Thomas A. Andrew, the chief medical examiner for the state of New Hampshire.

Dr. Andrew first learned about asphyxiation games in 2001, when he was asked to do an autopsy on a 13-year-old boy. He ruled the boy’s death a suicide. Further investigation, and the death of a 12-year-old boy in a nearby town under similar circumstances, prompted him to change his ruling on that death to accidental.

Anecdotal Statistics

The number of minors in the United States who might be dying from asphyxial activities is completely anecdotal, with estimates ranging from fewer than 100 deaths per year to more than 500. Neither figure has any solid basis in data, experts warn, and little research on the subject exists.

Sometimes, such practices take place in groups, in which participants are able to revive each other if one loses consciousness. In some cases, participants hold their breath or hyperventilate to pass out; in others, they use some kind of ligature, such as a belt or cord, to choke off their air supply. Deaths occur most often when people engage in the practice alone, using a ligature.

Asphyxiation in conjunction with masturbation has been a cause of such deaths, most commonly among young adult males. Pamela C. Cantor, a lecturer in psychology at the Harvard Medical School and a past president of the American Association of Suicidology, said she first encountered descriptions of what is known as autoerotic asphyxiation in the 1960s.

“My guess is that this is some kind of sexual activity,” Ms. Cantor said of recent deaths attributed to the choking game. She lectures in schools and to groups across the country about recognition and prevention of risky adolescent behavior.

Others say the choking game—also known by such names as space monkey, gasper, choke out, and cloud nine—appears to have no sexual intent among many young people.

“For most of the young people to which I have spoken, it’s about getting a high and not more than that,” said Dr. Joseph R. Zanga, a Greenville, N.C., pediatrician and a past president of the American Academy of Pediatricians.

Since Coty Mills’ death, Ms. Mills has become a crusader in her community, trying to get the word out to the 1,700-student Lunenburg district that the choking game has fatal consequences. But while the community has embraced her, she believes a few people are still not ready to listen to her message.

“People are afraid for you to speak because they’re afraid you’re going to have copycatting,” Ms. Mills said one day last month, a few hours after addressing a group of about 45 people gathered at the same middle school her son attended. Though the district allowed her to use the school as a gathering place, it declined to send fliers about the event home with the students.

“They’re afraid that some kid is going to go home and try it,” said Ms. Mills, who was so determined that youths in her community see the dangers of the “game” that she insisted her son’s casket be left open. Hundreds of people attended his funeral.

Wayne Staples, the superintendent of the Lunenburg district, said his system does not send any notices home with students that aren’t directly school-related. He attended Ms. Mills’ May 10 presentation, and said he thought she did a good job explaining that asphyxiation “games” can take place without parents being aware.

“I wish there had been more people there,” Mr. Staples said of the event.

The 15,000-student Springfield, Ill., district has also wrestled with how to deal with the subject.

“I’m truthful when I say I’m really agonizing over this,” said Robin M. Yoggerst, a student-support leader in the district, where an 11-year-old died in June 2005 from an accidental asphyxiation that some believe resulted from the choking game.

While she said the subject is appropriate to raise with adults, administrators are more wary of talking to students about it.

“It’s not like we want to glamorize anything,” Ms. Yoggerst said.

Outreach Efforts

Kate Blake, whose 11-year-old son, Dylan, died last October when he looped a belt around his neck and attached the other end to his bunk bed, said the superintendent of the 14,600-student St. Johns County, Fla., district, Joseph Joyner, was receptive to her request that information about asphyxial activities be widely publicized among parents. The principal of her son’s school, she believes, was less so.

“At the lower level, they just don’t want to deal with it,” said Ms. Blake, who lives in St. Augustine, Fla., and has created an extensive Web site to disseminate information about the choking game, dylan-the-boy-blake.com. “More often than not, the response I get is, ‘We don’t want to plant the seed.’ ”

David D. Baker, the superintendent of the 4,700-student Springboro, Ohio, district, has heard some of that grumbling. He heard about the choking game, then got reports that a group of 3rd graders in his district were playing a game to see who could hold their breath the longest.

Administrators brought the children together in January and told them the practice was dangerous. Then, Mr. Baker sent a letter to parents explaining the dangers of asphyxial activities. Administrators also gathered the school’s entire 3rd grade class for an assembly to warn them about the game.

“We had some parents upset with me,” Mr. Baker said. “They thought that I was accusing their children.”

But from Mr. Baker’s perspective, he was trying to reach out to students before anyone got hurt. “I’ll never know how many kids were saved because we put it out there,” Mr. Baker said of the outreach effort.

From the perspective of health professionals, alerting parents about the specific dangers of the choking game is a good approach. For students, general warnings about the activity can be incorporated into lessons about other risky behaviors, they say.

Asphyxial activities should be addressed the same way as behaviors such as smoking and “huffing,” or inhaling chemicals to get high, said Dr. Andrew, the New Hampshire medical examiner. “The same administrators probably wouldn’t object to a flier about smoking,” he said, “so why would they object to this?”

Ms. Blake, the Florida mother who lost a son, said schools must acknowledge that the activities are happening and talk to parents about them, along with other risky youth behaviors, such as drug use.

“That’s the easiest and most resourceful way to do it,” Ms. Blake said. “My mission is, I don’t want to reinvent the wheel. I just want to add a spoke.”

In districts where students have died from asphyxial practices, administrators say they tried to address the problem comprehensively: warning parents, while reminding students that they need to tell trusted adults if they hear about or see their classmates engaging in such behaviors.

Ann E. Shortt, the superintendent of the 14,500-student Fairbanks North Star Borough district in Fairbanks, Alaska, said her district sent letters home to all parents after 13-year-old Andrew Freeman died from what was believed to be the choking game on March 29, the same day as Coty Mills.

In addition, the district plans two “safety summits” for parents that will focus on asphyxial activities, as well as on Internet safety and bullying. The district is also reaching out to community groups such as churches.

“Our philosophy is to communicate as much as we can with parents, as quickly as we have accurate information,” Ms. Shortt said. In this case, as in many others, the parents were advocates for getting the word out to the community.

“They were so supportive of us,” Ms. Shortt said. “Very open.”