When Missy suggests playing "Rock, Paper, Scissors" to decide what they should do, Sheldon tells his twin that won't work. He says studies show people familiar with each other match over 75% of the time. Missy suggests adding two more options: "Rock, Paper, Scissors, Candy, Pony". Sheldon tells her she's just being silly. In The Big Bang Theory (2007), Sheldon would use a version of "Rock, Paper, Scissors" created by Sam Kass that adds two additional items: "Rock, Paper, Scissors, Lizard, Spock". Scissors cuts Paper, Paper covers Rock, Rock crushes Lizard, Lizard poisons Spock, Spock smashes Scissors, Scissors decapitates Lizard, Lizard eats Paper, Paper disproves Spock, Spock vaporizes Rock and as it always has, Rock crushes Scissors.
When Dale picks up Dr. Sturgis standing in front of his home, the shot was filmed at the cluster of apartment buildings along Morning Glory Circle (Blondie Street) on the Warner Ranch backlot. This location was also used for the opening theme of the Friends (1994) television series. They're also catercorner to Meemaw's house. In the spring of 2023, after 88 years, the whole backlot was torn down to make way for more studio buildings.
In the beginning of the episode, Sheldon can be seen reading Frank Herbert's science fiction novel, Dune.
Sheldon's grandfather's name is "Charlie Tucker". This could be a reference to the character Charles "Trip" Tucker from Star Trek: Enterprise (2001).
The items on the Game Challenges Master List are: "Getting Tickled Word Search", "Staring Competition Trivia", "Thumb War Checkers", "Perfection Operation", "Blindfolded Bowties", "Backwards Alphabet Hopscotch", "Hula-Hoop Name the States", "Solar System Ring Toss", "One-Legged Simon", "Name An Ocean Go Fish", "Famous Inventors Guess Who", "Dictionary Pictionary", "Cabbage Patch Train Track Challenge", "Skip-It Spelling Bee", "Beetle or Beatle", "Easy-Bake Addition", "Telling Time Jumping Jacks", "Slap Bracelet Fractions", "Scented Marker Scrabble" and "Hold Your Breath Crossword". "Hula-Hoop Name the States", "Perfection Operation", "Thumb War Checkers" and "One-Legged Simon" are all shown. It also appears that Sheldon uses a 20-sided dice to determine which challenge they shall do next.