Although we didn't do this as kids, I can see now how this song could be used as a simple game. The person who is "it" picks the substitution word (ie river...riverside) and sings the verse. The rest join in the chorus and when they get to "sticks all over you," "it" points to another person who then becomes "it" and picks the next words. For more advanced groups, if someone duplicates a verse or fails to respond, they are "out" and the game continues until only one is left, the winner. For even more advanced groups (adults) the rule could be that the second substitution word has to end with "cide" as in my examples above, not "side". But as kids, we sang the verses with "side" as Rechal contributed, - except for the "sewer...suicide" one.