Dr. Gary’s Therapeutic Cootie Game

Over 50 million copies of the Cootie game have been sold since it was introduced in 1949. The Cootie game is a great preschool game that consists of a picture board depicting all the game parts, Cootie body parts (body, head, antennae, proboscis, eyes, 6 legs), and a die.

This modified version of the Cootie game introduces a therapeutic element. The versions described below focus on social skills and depression, but any story can be written to work with any number of issues and challenges.

The Basics: The object of the game is for each of the players to construct their own “Cootie”. The first player to do so wins the game. In the therapeutic version, it is not necessary to have a winner; the goal is to complete the story.

Game Play: Each part of the body is identified by a number as follows: 1-Body, 2-Head, 3-Antennae, 4-Eye, 5-Proboscis, and 6-Legs. There are two ways to begin the game. Each player rolls the Die once and the high score starts the game, or the youngest (visitor) may go first.


Each player tries to get the body of the Cootie by rolling a “one” spot. If he succeeds, he gets a free roll of the Die to try for the head. The body and the head must be obtained in the order named, before any other parts of the Cootie can be attached. The legs, eyes, antennae, and proboscis can be acquired in any order; all are eligible after the body and head are obtained. The player loses the Die when he fails to roll the number for an eligible part that they have not yet acquired. For example, if the player rolls a 4 and already has the eyes, then the die gets passed to the next player. If they roll a 4 and don’t yet have the eyes, they pick them up and roll again.

One body, one head, eyes, two antennae, one proboscis, and six legs are required to make a complete Cootie.

As mentioned, in regular game play, once the body and head are acquired all the other body parts can be acquired in any order. In the therapeutic version of the game, however, parts are acquired but must be added to the Cootie in order, so that a story can be told that makes sense. If a part is acquired out of order—for example a leg before Cootie has a proboscis—the part is picked up and set aside until it can be added.

Social Skills Story
When a one is rolled and the body is acquired each player says: “Cootie wants to play.” When a two is rolled and the head is acquired each play says: “Cootie wants to play with ____________ (choose the fellow player, a peer, or a sibling).” Players are now eligible to acquire body parts in any order, but they are added to Cootie in the order listed below.

When the eyes are acquired each player says: “Cootie is going to look at __________when Cootie speaks. Cootie is going to look at _________ when ___________ talks” and the player attaches the eyes to Cootie. If the player has already acquired the antennae, they can now be added.

When the antennae are acquired and added each player says: “Cootie is going to listen carefully when __________ talks” as they attach the antennae to the head.

When the proboscis is acquired each player says: “Cootie is going to keep his/her tongue, feet, and hands to herself when she plays” as they add the proboscis to Cootie.

Each leg represents a skill or affirmation, depending on the child’s needs. Here are some examples:

  • Leg 1: Cootie says, “Do you want to play with me.”
    • Leg 2: Cootie tells himself: “I won’t get mad if someone says no, I’ll find someone else to play with.”
    • Leg 3: Cootie says: “You’re the guest. What do you want to play?”
    • Leg 4: Cootie tells himself: “Make sure your friend is having fun.”
    • Leg 5: Cootie says: “Thanks for playing with me. I had fun!”
    • Leg 6: Cooties tells himself: “I did a good job taking turns and sharing today.”

After each Cootie is completed, the story is retold, repeating each statement as the appropriate body part is pointed to.

Alternative version for a depressed child
When a one is rolled and the body is acquired each player says: “Cootie doesn’t want to be sad and bored today.”

When a two is rolled and the head is acquired each play says: “Cootie is going to think of three things he can do today.” The therapist can prompt the child, or make suggestions.

When the eyes are acquired each player says: “Cootie looks for Mom (Dad, teacher, sibling) and gives them a hug” and the player attaches the eyes to Cootie. If the player has already acquired the antennae, then they can now be added.

When the antennae are acquired and added each player says: “Cootie tells himself one thing he likes about his life” as they attach the antennae to the head (the therapist can ask the child to identify that one thing, or make a suggestion).

When the proboscis is acquired each player says: “Cootie enjoys tasty food. The tastiest food I had this week is __________” as they add the proboscis to Cootie.

Again, each leg represents a skill or affirmation, depending on the child’s needs. Here are some examples:

  • Leg 1: Cootie says, “I don’t have to be bored. I can find something to do.”
    • Leg 2: Cootie tells himself: “I don’t have to be sad all the time. I can be happy when _____________.”
    • Leg 3: Cootie says: “Two things I like about my life are __________ and __________.”
    • Leg 4: Cootie tells himself: “The person who can help me when I’m sad is ___________.”
    • Leg 5: Cootie says: “I am beautiful.” And then Cootie says it again really loud, “I AM BEAUTIFUL.”
    • Leg 6: Cootie tells himself: “I am good at ________________.”

Again, after each Cootie is completed, the story is retold, repeating each statement as the
appropriate body part is pointed to.

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