Abdominal thrusts can also be performed on oneself with the help of the objects near, for example: by leaning over a chair. Anyway, when the choking victim is oneself, one of the more reliable options is the usage of any specific anti-choking device. In adults, there is limited evidence that the head down position can be used for self-treatment of suffocation and appears to be an option only if other maneuvers do not work. In contrast, in children under 1 it is recommended that the child be placed in a head down position as this appears to help increase the effectiveness of back slaps and abdominal thrusts.