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The parents of a Mt. Lebanon teenager who died in his room believe their son accidentally strangled himself playing the "choking game," a dangerous activity adolescents use to get a cheap "high" without drugs.

The Allegheny County Office of the Medical Examiner said the 13-year-old boy died Monday of "asphyxiation due to hanging," and is investigating whether the death was a suicide or the result of a game popular among adolescents. The children -- either alone or together -- choke themselves, depriving their brains of oxygen to get a light-headed feeling.

"It's a horrible game, the passing-out game, and parents need to be aware. But more importantly, the kids need to be educated that it's a bad, bad thing to do," said the boy's father, who talked with the Pittsburgh Tribune-Review on the condition of anonymity. He wants to prevent another death. "This is dangerous. This is like playing Russian roulette."

The Mt. Lebanon School District plans to send a letter to parents by the end of February, inviting them to a panel discussion about high-risk behaviors among children, including the choking game, said district spokeswoman Cissy Bowman.

Parents can use news reports of the boy's death to ask their children if they play the game, said Christy Stubor, an outreach coordinator for CONTACT Pittsburgh, a 24-hour crisis and suicide hotline. Children who are uncomfortable talking to their parents can call CONTACT Pittsburgh anonymously at 412-820-HELP, Stubor said.

The school district sent a letter to Jefferson Middle School parents informing them of the death, and counselors and psychologists are helping students and staff cope, said Mt. Lebanon School Board President Joe Rodella.

"Our complete focus is trying to help our students and staff get through this tragic loss of their classmate," Rodella said. "I can't imagine what the family's going through. The loss of a child is by far the most frightening circumstance for any parent, and my heart goes out to them."

The medical examiner's office does not keep statistics on deaths in the county from the game, and there are no national statistics. But a Tribune-Review survey of newspaper articles online found that hundreds of U.S. children have died playing the game in the last few years.

Adolescents often play the game together by either choking themselves or letting their friends choke them, cutting off the flow of oxygen-rich blood to the brain until their eyes roll back in their heads, said Dr. Chris King, an emergency medicine physician at Children's Hospital of Pittsburgh.

"It creates a kind of euphoria," he said. "This is for fun, supposedly."

The children generally stay unconscious for a minute or so, and then quickly recover as blood flow resumes, King said. If it does not resume within five minutes, brain damage is likely to occur, he said.

"It's important for parents to talk to their kids and say, 'This is not what smart kids do. This is not fun. It's not a game; it's stupid,'" King said. "You can end up with brain damage or die."

Mike Manko, spokesman for Allegheny County District Attorney Stephen A. Zappala Jr., makes regular presentations to school students about drugs, alcohol and peer pressure. Eight months ago, he added a segment about the choking game to his presentation, in response to increasing national reports about kids playing the game.

He has not given the presentation to the Mt. Lebanon School District.

"Children as young as 8 and 9 are doing it," said Manko. "Some kids get used to it, and they want to do it when they have nobody around, so they do it with a rope or belt."

As they begin to get light-headed, children lose the ability to loosen the ligature and can die from lack of oxygen.

"This probably wasn't the first time. He probably did it with other kids," said the teen's father, adding that the boy's friends denied playing the game.

The popular Jefferson Middle School 8th-grader came home from classes in a good mood and had an enjoyable dinner with his family, his father said. He then went to his bedroom to do his homework.

After about an hour, his mother checked on him and discovered her son slumped over in a corner with a belt around his neck. His face was blue.

She began cardiopulmonary resuscitation while one of the teen's four young siblings called his father and an ambulance. He died at St. Clair Hospital in Mt. Lebanon an hour later, according to the medical examiner's office.

"He was a sweet boy, and he didn't deserve this," his father said.

The funeral service at Temple Emanuel Synagogue was "heart-wrenching," wrote Ruby Kang, president of the Jefferson Middle School PTA. The boy was remembered "as a hard-working, kind and gentle young man," Kang wrote in response to an e-mail query from the Trib.

The teen's father read heartfelt Mother's Day and Father's Day cards from his son, and told mourners that his death was an accident.

"He didn't leave a note -- this wasn't a boy who was trying to kill himself," the father said.

Children who play the game aren't trying to die, said King, who likened it to an accidental drug overdose.

"The problem is that, just like street drugs, it's hard to (measure) the exact amount of oxygen deprivation," King said. "If you overshoot a little bit, you die."

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