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Health & Fitness: Risky Behavior

A letter from Roger Oxendale, President and CEO.
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Risky Behavior graphic

Your adolescent will make mistakes. Try not to get too upset. Choose your battles and mix criticism with praise. If you negotiate and compromise, your teen can learn to take responsibility for his actions.
Remember: You’re a parent – not a pal.

The Choking Game

Also called: Space Cowboy, Space Monkey, Choke Out, Cloud Nine, Suffocation Roulette, Dreaming Game, Fainting Game, Flatline Game, Funky Chicken.

You may wonder why this death-defying pastime is called a game. The kids who do it are cutting off the flow of blood and oxygen to the brain. They achieve a brief high, a kind of euphoric state, when the pressure on their arteries is released and the blood flow resumes.

They don’t see the harm (after all, they’re not into drugs or alcohol). Not until they’re shocked by the death of a friend who never woke up after passing out. Not until a friend suffers a stroke or seizures from the effects of blood pressure changes while tightening and loosening the rope or belt.

“These teens are caught up in a spiral of peer pressure and risky behaviors,’’ says pediatrician David Wolfson, MD. “They aren’t out to hurt themselves.’’

What can a parent do?

Check on your child periodically in his bedroom, even when he says he’s going up to listen to music or do his homework. And check whether there are red marks on his neck.

The most important thing is to talk to your kids about just how perilous the Choking Game is – and do it now, says Dr. Wolfson, medical director of Children’s Community Pediatrics of Children’s Hospital of Pittsburgh. If you’re uncomfortable, make an appointment with the pediatrician.

And – together – come up with a reliable “exit strategy” that will get them out of a precarious situation. “I tell teens that while they may not be able to predict a situation, they need to take responsibility to get out of it,’’ he says.

A recommendation: Tell your child he can call you at anytime, from anyplace. No questions asked. You’ll pick him up to take him home

Risky Behavior

There’s a reason your teenagers sometimes baffle you with their dumb decisions. Their brains are growing in a way that makes them more prone to outrageous behavior – like driving too fast and experimenting with drugs and alcohol. They want to be treated like adults, but their brains are on a bumpy ride of development.

Until fairly recently, scientists believed that the production and development of gray matter occurred only during the first 18 months of life. They’ve since learned that there’s another brain growth spurt starting at about age 11 that isn’t completely hardwired until the early 20s.

The problem during this stage of development is that the rational part of the brain, known as the prefrontal cortex, seems to be overtaken by the emotional part, the amygdala. When you add puberty’s surging hormones to the mix, the result can be unpredictable, moody and irrational behavior.
“When you ask your teenager, who went off drinking with his buddies, ‘What were you thinking?’ you have to know he wasn’t thinking,’’ says Pamela J. Murray, MD, MPH, chief of Adolescent Medicine at Children’s Hospital of Pittsburgh. “He was going with his emotions. That’s why it’s important for parents to pay attention to what their kids are doing.”

While the irrational choices teens make can be as harmless as dyeing their hair pink, they also can be destructive when they turn to self-mutilation by cutting themselves or deadly when they try choking themselves for a fleeting high.

Explain risks- ask questions - stay engaged

Kids are under a lot of stress – to get good grades, participate in activities and socialize with friends. They crave acceptance. These destructive behaviors appear to be their answer to reducing anxieties. The danger, of course, is that they can seriously hurt themselves, and even die.

If only there were simple solutions. Parents may think their kids were listening when they sat at the kitchen table discussing the hazards of drinking and driving, and of smoking cigarettes and using drugs.

“They are listening, but they don’t really hear you,” says A. Michele Tedder, RN, BSN, who counsels teens at Children’s Hospital. “Their knowledge and behavior are worlds apart.”

That doesn’t mean parents should give up, says Mrs. Tedder, project coordinator for the Reaching Out to Adolescents with Depression (ROAD) program at Western Psychiatric Institute & Clinic, part of University of Pittsburgh Medical Center. “At the end of the day, it comes down to choices, and we have to keep working at equipping our children with the tools to make better choices.”

Dr. Murray and Mrs. Tedder offer suggestions to help you and your child weather the storm of adolescence:

  • Know your child’s baseline behavior – that is, what is normal for your child. Be alert for a gregarious child who suddenly becomes withdrawn, for example.
  • Try to find common ground. “If he’s introverted, find things you can do together – like watch sports videos,’’ says Ms. Tedder.
  • Become technologically literate so you can institute parental controls on the use of the Internet.


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