700 Children's® – A Blog by Pediatric Experts

Specialty Evaluations in Therapeutic Recreation

Feb 12, 2026
A smiling boy with light hair and glasses sits in a custom adaptive handcycle on a wooded trail. He wears a t-shirt and shorts, surrounded by trees and dappled sunlight

Can you remember the first time you rode a bike, or started a new video game and could escape into a world to explore? These are two experiences that many people have and remember for a long time. Now what if you had a difficult time riding a regular bike or playing a video game? That is where Therapeutic Recreation comes in. 

Therapeutic Recreation (TR) is a type of therapy that uses recreation and leisure activities to improve health and well-being. A Certified Therapeutic Recreation Specialist (CTRS) helps people of all ages and abilities to find activities they enjoy, build skills and use fun experiences to support a healthy lifestyle.

Sometimes children and families need support to find more specialized equipment and resources to help them do the activities they enjoy. In some hospitals, skilled CTRSs may offer adaptive biking and adaptive gaming evaluations. These services help kids and families be able to successfully ride a bike or tricycle or play video games. 

In biking evaluations, a CTRS can show children and families different adaptive bicycles (bikes) and tricycles (trikes) that are specially designed or adjusted so people with different abilities can ride them safely and comfortably. Biking is a great way for people to get moving and feel better in their body and mind. Being able to ride a bike can help muscles grow stronger, improve coordination, boost confidence and promote independence as people are able to move on their own.

For adaptive gaming evaluations, the CTRS can help people who have trouble pressing buttons, moving joysticks, or holding a regular controller. Some people need extra support because of muscle movement or coordination challenges. By finding different controllers and equipment, people can then join in with their friends, family, and the online gaming community to play together and be included. Also, playing video games can boost problem-solving skills, support emotional health, and help maintain physical skills.

As a CTRS, I often have the privilege of getting to see kids ride a bike or trike for the first time when they come to an evaluation. It is an amazing moment to see the smile on a child’s face when they feel the freedom of a bike or trike ride. I see the same joy when kids are able to use a game controller when they have limited use of one of their hands and can now play one of their favorite video games. These are just a few examples of the rewarding field of Therapeutic Recreation!

Interested in receiving an adaptive biking or adaptive gaming evaluation for your child? Connect with your child’s primary care provider or physician to request a referral to the Therapeutic Recreation department at Nationwide Children’s Hospital for these services.

Featured Expert

Portrait of Christine Havach. Christine is wearing a pink Nationwide Children's Hospital t-shirt.
Christine Havach, MA, CTRS
Clinical Therapies

Christine Havach, MA, CTRS, has been practicing as a certified therapeutic recreation therapist since 2008. She has worked extensively with adult and adolescent behavioral health but joined the Nationwide Children's Physical Rehab unit in November 2019. She also assists with a variety of other populations/diagnoses including behavioral health, oncology, cardiovascular health, among others. She uses an extensive array of interventions to promote healthly leisure habits but particularly enjoys using creative expression activities, physically active games and social/interactive activities.

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700 Children’s® features the most current pediatric health care information and research from our pediatric experts – physicians and specialists who have seen it all. Many of them are parents and bring a special understanding to what our patients and families experience. If you have a child – or care for a child – 700 Children’s was created especially for you.