"The most common ones are blood shot eyes, red marks on the neck, severe and frequent headaches and things in their bedroom that seem out of place like a bungee cord or a dog leash," she said.
Toblin said other signs include, but are not limited to: seizures; disorientation after spending time alone; changes in behavior, such as becoming overly aggressive or agitated; or a thud in the bedroom or against a wall, meaning a fall in a case where a child is participating in the game alone.
The youths who are participating in this game aren't the ones who one might expect, Toblin said. They're generally high achieving, motivated, active participants in their community. One motivation, besides the rush or sense of euphoria that is achieved, is that participants might be looking for some sort of thrill without getting caught with drugs or alcohol.
"These are good kids, smart kids that don't drink and do drugs and they're goofing around with this stuff," said Culbert.
Last year, there were 13 deaths across the U.S. associated with the game, according to the CDC. By the end of this year it looks like the numbers will be similar, Toblin said, but deaths are often times mistaken for suicides, so it's hard to determine how many deaths were actually caused by the game.
"We don't have a percentage because we are using newspaper reports for finding potential cases but we do know that in 2007 there were 13 deaths and currently in 2008 it looks like we're on the same path to end up with about 13 deaths," said Toblin.
However, there is one great measure that can be taken to prevent your children from participating in this risky activity, Toblin said: education.
"Get parents aware of the choking game, because the children that die almost [always] were alone at home in their bedrooms teach parents about warning signs," said Toblin.
"We can reach the kids but I think the parents need to know to talk to their kids, too My big concern was that parents needed to pay attention to this and they need to talk to their kids about how dangerous this is," said Culbert.
For information on the "Choking Game," visit the CDC's Web site on the subject, www.cdc.gov/Features/ChokingGame.""