When my daughter was small, it was relatively easy to work rehabilitation exercises into our day. I took her to the park and showed her that she needed to extend her right arm when she climbed on the play structure even if her hand was closed-up in a fist, I stretched her muscles as often as I could while I held her, and I invented all kinds of games based on the exercises that she needed to do (the “variations” that I wrote about in my book). 

As she got older, however, and started asserting herself, as children do, I moved to the “illusion of choice” approach as I wrote about earlier. Letting my daughter feel she was a part of the decision-making process and had some choice in the matter, even if I had structured the choices to favour the integration of her exercises into an activity, went a long way to getting her to do what had to get done. 

The “illusion of choice” has actually been effective in other areas as well. Both my daughters have very good study habits and I think, to a great extent, it’s because they know they get the work done first, and then they can have all the free time they want. In the early years, the “illusion” in this case was that if they chose to get their work done first (like on a Saturday morning, right after breakfast) then we could have the rest of the day together after that. Within a relatively short period of time, they saw the benefits of getting their work out of the way so that they not only had the rest of the time to themselves, they also didn’t have to stress about what they hadn’t yet done as the weekend came to a close. And, with time, this approach became a regular habit so there was no longer any need for an “illusion”. 

In terms of my daughter’s rehabilitation, as she is getting older (and of course, increasingly asserting herself...), she understands the link between the exercises that she needs to do and her own progress. And, this realization has become a powerful motivator for her. For example, she wanted to learn how to cross-country ski but she was unable to use a pole with her right arm (yet...). To help her, her occupational and physiotherapists suggested a series of exercises and strategies to strengthen her arm and adapt the approach. So great was her interest in learning to ski, that she took the initiative to do those exercises on her own. Of course, going back to our “illusion of choice” days, she did them in front of the TV.

But that doesn’t matter, she is doing what needs to be done—there is no longer an illusion of choice, it is her own choice.