This project involves the development and testing of a low-cost, home-based virtual reality therapy program that capitalizes on children’s interest in video games and their ability to promote physiological change with increased feedback and motivation through repetitive play and increasing complexity of tasks. More specifically, children are rewarded for using their hemiplegic hand when playing video games. Wrist movements are motion-captured in order to facilitate fine motor rehabilitation. Games can be adapted to each child’s abilities and rehabilitative needs and come with online tracking and feedback modules. The system includes an extensive library of video games to encourage and retain participation. Testing of this system was conducted simultaneously with development, in partnership with children and their families.