My child came home from school saying that they learned to cough and sneeze into their elbow with Germy Wormie, and I was totally taken aback. I always covered with my hands. But I went to the website and now I get it, hands touch, elbows don't!! Kids can touch 300 surfaces in 1/2 hour and they hate to wash their hands. There is also a DVD that teaches them in a fun way the elbow cough, as well as other necessary hygiene habits.