School officials in New Jersey have confirmed the recent death of a teen who met their demise while playing something called "the choking game," a disturbing fad in which children try to cut off their oxygen to experience a brief rush of euphoria.

Nick Markarian, the Superintendent of Schools in Bernards Township, NJ, wrote a letter to parents this week informing them that one of three recent student deaths in the district was due to the "choking game," which is also known as "Pass Out Challenge," "Knock Out," "Tap Out," "Hangman," "Space Monkey," "Fainting Game," "Airplaning," "Black Out," "Elevator" and "Flatliner."

The "game" is apparently popular with children ages 9 to 16 thanks to the proliferation of videos on YouTube, and involves a child, either on their own or with the help of a friend, cutting off their oxygen by tying neckties, belts, ropes and other bands around their necks. The Centers for Disease Control and Prevention reported that the game took 82 lives between the years 1995 and 2007, though more recent hard data is not currently available. Last year, media outlets reported that the "game" was making a comeback.

"It is important to emphasize that research shows children who experiment with the 'choking game' alone often tragically die after the first or second time," Markarian wrote in his letter. "Many of our children have easy access to videos via YouTube depicting others participating in this activity."

He added, "The early-adolescent brain does not process information in the same manner as an adult brain, and so children in this age group are not able to fully understand the serious consequences that might result." Markarian urged parents to talk to their children about the "game," and to check their internet search history.

Though the school did not identify which child succumbed to the "game," three students in the district's middle and high school have died since March 2016. Markarian warned parents to look for clues that might indicate their child is playing the game, including "knots in neckties, belts, ropes, or plastic bags left in bedrooms or other private locations," along with "bloodshot eyes, broken-blood vessels on the face and eyelids, mood swings, signs of disorientation after being alone, frequent and sometimes severe headaches, and bruises or marks around the neck."

Using coroner's office information, the international group Games Adolescents Shouldn't Play [GASP] has reported 45 suicides and 10 accidental deaths in New Jersey connected to the "choking game" between 1995 and 2004. But nationwide, the number of "choking game" deaths reportedly declined in the past decade, from 105 in 2006 to 4 in 2016.

According GASP, parents who suspect their child might be playing the game should "[b]e proactive and warn them about this activity—they often don't know it can kill them or leave them brain damaged. Supervise him or her very closely, and check that siblings are not involved. Dispose of items that could be used for this purpose. Alert school officials so they can monitor the situation; often other students may also be participating. Consider alerting the adolescent’s friends’ parents as well. If you feel strongly that your child may be doing this, seek professional counseling and support for your child and your family."