Gamifying my Son's Physiotherapy

Context

My oldest son is 5 years old at the time of writing this post. He has Cerebral Palsy (fairly mild, but still affects motor control of his legs). To ensure he strengthens and improves his mobility, we are constantly doing physiotherapy. Between physiotherapy appointments, we supplement with daily at-home stretches and exercises.

Trying to explain and motivate a young child on the benefits of physiotherapy is challenging. He doesn’t quite understand the long-term benefits and implications of it. The other aspect is that there are always more fun and interesting things to be doing other than stretches and exercises.

As my son loves to play video games with me and loves the idea of having missions/quests. We decided to try and gamify things to help motivate him to complete at-home physiotherapy.

Solution

Note: We’ve only been using this approach for about two weeks. We’re still figuring out the best tactics and whether this will work long-term for us. Early results are promising.

Enter Habitica! It’s a web/mobile application that gamifies habits and tasks. You are represented by an avatar that can level up, go on quests, gain money, and purchase rewards/equipment/pets.

Due to my son’s age, this is something that only my wife and I have access to on our mobile devices. Habitica operates on grounds of trust and discipline to ensure you don’t cheat the gamification as you have to set your own rewards. We all discussed the habits and tasks together and ensured that the difficulties are valid (as rewards are based on the level of difficulty).

How we use Habitica

Habits

Habits are core to Habitica and are the most flexible tool available. You are able to specify multiple habits and their respective difficulty. A habit can offer positive or negative reinforcement (via the +/- buttons).

Entries in this section are for things that happen on an irregular basis (i.e., behaviours), or things that are recurrent but not necessarily daily.

I found that breaking the habits up by a section is a nice hack. By using a habit with no positive/negative reinforcement, this is easily achievable (see above image).

Dailies

These are tasks that have to be done each day, which is where our exercises and stretches end up fitting in. The notes help us as well, giving us some numeric goals to hit for each one.

The novel aspect with dailies is that if they are not completed by the end of the day, then the avatar takes damage and loses some health. The dailies also help out by providing positive rewards in the form of quest progression, money, and experience.

You can pause the damage though, which can be good if the dailies cannot be completed due to specific circumstances (i.e., spending the day at grandparents, illness, etc.).

Tasks

To be honest, we haven’t used much of this section, but it is a basic to-do list. One-off tasks would fit in here, but from a chore/behaviour/exercise perspective, those tasks would fit better under habits or dailies.

Rewards

Every action in Habitica provides some level of reward in the form of experience points, gold, or random item drops. The experience points end up leveling up the avatar (which also provides a full health recovery). Items are either equipment or mechanics surrounding pets.

You can use gold to buy items like equipment, health potions, and pet-related items. The interesting aspect of gold is you can buy custom rewards that you’ve created. For example, for 10 gold my son can buy 15 more minutes on his iPad (or video game console). These custom rewards provide real-world motivation.

Party Quests

This is a nice piece in Habitica that my son enjoys. You are able to embark on quests with a group (although we just go solo – but could be fun with family/friends). These quests can be things like battling a monster or finding items. The progress is based on the completion of the dailies and habits. When you complete a quest you gain extra rewards.

Items/Pets/Equipments/Classes/Skills

You are able to buy and equip new equipment for your avatar (which changes their appearance) and raise pets. These are all little things, but they add to the element of progression and personalization.

We haven’t really gotten far enough yet to figure out the minor nuances with these features, but they can only add to the experience.

Results Thus Far

The results have been good so far, although it is likely too early to tell if my son’s enthusiasm will wane as time goes on. He likes to do his exercises as he enjoys checking off the dailies and seeing how much progress he’ll make in the current quest. He looks forward to seeing how much experience he needs to achieve the next level, and the little cosmetics on equipment and pets are also a nice touch.

The habits section is nice, although I feel like it can become unwieldy depending on how many things get slotted in there. I feel that this is a section I’ll likely cap at 10~ things total. My son has done good things and he would say, “Can we put that in Habitica?” which makes me chuckle. The negative habits are hit or miss in my opinion as in the moment it isn’t the greatest to pull your phone out to do it.

Overall, Habitica is a nice tool we have at our disposal. Like all things, we’ll keep an eye on it and see if it is fulfilling its purpose – motivation for daily exercises, stretches, and chores.

As we’re working on reading, a lot of the direction and usage is completely guided by us, the parents. I am curious to see how this plays out when he can read more.

One last thing for anyone who wants to let their child have their own account, Habitica has a policy for those under 13. It requires their parent or guardian to provide permission and makes it so the public social aspects get locked down.