Achoo! Catch It, Bin It

A pretend-sneeze reaction game that drills what to do in the one second before a real sneeze or cough — catch it in a tissue or your elbow, bin it, wash.

  1. See the spray. Outside or at the bath, squirt a spray bottle of water into the air. “That’s what a sneeze does — tiny wet drops fly out, and germs ride on them.” Then squirt it into a tissue, and into the crook of your elbow — the spray is caught.
  2. Teach two catches. Tissue catch — cover nose and mouth with a tissue. Elbow catch — if there’s no tissue in reach, bury nose and mouth in the bend of the elbow (the “vampire cape”). Never the bare hand — hands touch everything.
  3. Play Achoo! Put a tissue box somewhere in the room. Walk, dance, or play normally. When you call “Ah… ah… ACHOO!” the child must catch the pretend sneeze. If the tissues are within two steps — tissue catch. If not — elbow catch.
  4. Finish the job. After a tissue catch, the tissue goes straight in the bin, then “soap hands” — a real wash, or a pretend one mid-game with a real one at the end.
  5. Swap roles. The child calls the sneezes and checks your catch. Get it wrong on purpose sometimes — sneeze into your hand and reach for a toy — and let them stop you.

Variation: add “cough-cough!” as a second signal with the same rule, or play it as a freeze game with music — when the music stops, a sneeze is coming.

Requirements

  • Space: Any room with space to move about; outdoors or the bath for the spray demonstration
  • Surface: Any; a wipeable area for the water spray
  • Materials: Spray bottle with clean water, box of tissues, a bin, soap and water nearby
  • Participants: 1 adult + 1 child; works well with a group
  • Supervision: Light — adult leads the game and models the catches

Rationale & Objective

Blowing the nose is half of respiratory hygiene; covering coughs and sneezes and disposing of the tissue is the other half, and it has to happen as a reflex because a sneeze gives almost no warning. The CDC’s guidance is exactly the sequence drilled here — cover mouth and nose with a tissue, throw the used tissue away, use the elbow rather than the hands if no tissue is available, then wash hands. A five-year-old can recite that rule long before they can do it in time, so the skill needs many fast, playful repetitions: the call-and-respond format gives dozens of practice trials in a few minutes and builds the response into an automatic motor habit. Deciding between tissue and elbow adds a small, quick judgment that exercises inhibitory control (stopping the instinctive hand-to-mouth). The spray-bottle demonstration makes an invisible process visible, which is how preschoolers learn health concepts best. The Vineland Personal items include covering the mouth and nose when coughing or sneezing as an expected self-care behaviour, and Head Start ELOF (P-PMP 4) expects preschoolers to wash hands after blowing the nose.

Progress Indicators

  • Early: sneezes or coughs into the open air or into the palm; needs the adult to model each catch; leaves used tissues wherever they land
  • Developing: does an elbow or tissue catch in the game when reminded which to use; sometimes still uses the hand; bins the tissue when prompted
  • Proficient: catches pretend sneezes quickly and chooses tissue or elbow sensibly; bins the tissue and goes to wash hands without prompting during the game; beginning to cover real coughs and sneezes
  • Advanced: covers real, unexpected coughs and sneezes most of the time in everyday life; disposes of tissues and washes hands by themselves; kindly reminds others (“elbow catch!”) and can explain why hands are the wrong place

Safety Notes

  • Use only clean water in the spray bottle and never spray towards anyone’s face; a bottle that once held cleaning products is not suitable
  • Do the spray demonstration outdoors, over a sink, or at the bath so floors don’t become slippery
  • Keep the tone light — this is about being kind to the people around us, not about germs being frightening. Watch for anxious children who start to worry about getting ill
  • Never shame a child for a real uncovered sneeze; a calm “next time, elbow catch” teaches far more
  • A cough that lasts for weeks, sounds barking or wheezy, or comes with breathing difficulty needs a doctor, not a game

Hints

  • Playfulness: make the wind-up enormous — “Ah… aaah… AAAH…” — and sometimes don’t sneeze at all. The elbow catch can be a vampire swishing a cape or a superhero pose
  • Sustain interest: move the tissue box to a new spot each round, add the “cough-cough” signal, or keep a tally of how many real sneezes the whole family caught properly this week
  • Common mistake: teaching “cover your mouth” without saying with what — children then use the hand, which spreads germs to everything they touch next. Be specific — tissue or elbow
  • Limited space: play it sitting at the table or in the car using elbow catches only — no equipment needed at all
  • Cross-domain: fast stop-and-respond games build inhibitory control (executive function); talking about protecting baby siblings or grandparents builds empathy; count the catches (numeracy)
  • Progression: adult models each catch → child responds to a slow, obvious wind-up → surprise sneezes mid-play → child chooses tissue or elbow by distance → child leads the game → the habit shows up with real sneezes

Sources

  • CDC — “Coughing and Sneezing” hygiene etiquette (tissue, bin, elbow if no tissue, wash hands)
  • Head Start ELOF — P-PMP 4: child demonstrates personal hygiene and self-care skills
  • Vineland Adaptive Behavior Scales — Daily Living Skills (Personal) item on covering mouth and nose when coughing and sneezing
  • Montessori Practical Life — Grace and Courtesy and Care of Self (coughing, sneezing, and nose-blowing lessons)
  • AOTA (2020), Occupational Therapy Practice Framework, 4th ed. — ADLs: personal hygiene and grooming