The Impact of Robot Assisted Therapy and Metacognitive Skills Training for Children With Hemiparesis

Inclusion Criteria: * Child must be between 7 and 17 years of age at the start of the study. * Child must have hemiparesis with at least partial active grasp and release. * Child must be able to follow multi-step commands. * Child must have a caregiver available who can assist with implementation of home exercise program. * Child must speak English. * Child must have hemiparesis caused by cerebral vascular accident. * Child must have adequate insurance to cover evaluation, re-evaluations, and intervention, as this study will be billed to participants' insurance. Exclusion Criteria: * Child must not have received botulinum toxin or phenol injections within 4 months of and/or during intervention. * Child must have tone less than 3/4 on Modified Ashworth Scale. * Child must not be considered legally blind. * Child must not have contraindications for use of robot assisted device (ie. recent fracture or skin lesion). * Child must not be non-verbal. * Child must have not had reconstructive surgery to the affected upper extremity within the last year. * Child must not be receiving active oncology plan of care.