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Self-induced asphyxia (‘the choking game’)

Self-induced asphyxia, sometimes known as the choking game, is a growing and dangerous activity being undertaken by some children/young people. It has been around for over 60 years but the practice involves intentional strangulation, either alone or assisted.

The motivations for undertaking may include the misconception that there is no real danger, thrill-seeking, peer-pressure, challenge or dare and a curiosity in experimenting in an altered state of consciousness.  Please be aware children may talk openly about this practice referring to it in the following slang terms:

American dreamBlackoutKnockout game
TinglingBreath playChoke-out
Dream gameFainting gameSuffocation
RouletteFlatlinerCalifornia high
Space cowboySpace MonkeyFunky chicken


The dangers of participating in this activity include:

  • Blood deprivation to the brain kills millions of brain cells
  • The blood surge can cause stroke, fits and brain damage
  • Can cause death

Warning signs to look out for

This practice can be undertaken nearly anywhere with no props or tools necessary and the entire game can take less than five minutes from start to finish.

Signs to look out for:

  • Blood shot eyes
  • Frequent headaches
  • Bruise marks on the neck
  • Disorientation

Potential school action

  • All staff should be aware of the potential warning signs and understand the risks associated with the choking game and other such activities.
  • Responses should be in accordance with the school’s policies and the statutory safeguarding duties of school staff as directed in keeping Children Safe in Education, DfE Sept 2016. Concerns, including at what point to share information with the young person’s parents, should be discussed with the school’s designated safeguarding lead (DSL).
  • Where the school becomes aware that an incident has occurred, they must prioritise the safety of the young person. If necessary the situation should be dealt with as a medical emergency, administering first aid and summoning appropriate support. Actions and responses, including contacting parents, will be determined by the school’s first aid/emergency procedures policies.
  • Where these activities are undertaken with the intention to cause harm to another pupil, the incident should be dealt with under the school’s behaviour policy.
  • School may identify children and young people who are potentially vulnerable to participating in these behaviours and plan targeted interventions addressing risk management skills and approaches. It should be noted that adolescence, by its very nature, is a period when many young people take additional risks and identification of specific individuals may prove challenging.
  • Staff may want to add ‘key words’ to their on line monitoring software and scan computer use across the setting when terms are searched for, particularly cumulatively.
  • Schools may wish to provide parents/carers with information about the choking game and other risky activities, how to talk to their children about the issue, and where to access support. Workshops aimed at parents addressing how to keep their children safe may be helpful. Many schools share this information effectively on their school websites.

Curriculum (universal provision through planned PSHE and science)

  • High quality PSHE which includes appropriate learning around peer influence, risky behaviours, first aid, emotional health and wellbeing.
  • Statutory elements of the science curriculum in maintained schools covering healthy lifestyles on how the body functions.
  • Opportunities within a range of curriculum areas to explore risk, risky behaviour and why such behaviour might occur e.g. literacy texts.
  • Opportunities to learn about and develop ‘protective behaviours’ i.e. listening to what your body is telling you when something feels wrong, no problem is too big, small or awful to be shared with a trusted adult.

Updates and changes


These pages are updated regularly and should be used as the main source of information.  Printed versions should be used with care as they can become out of date.