Reyna was a slow-developing child with several active older brothers. She spent her early years attending their ballgames and tennis matches. Always there was opportunity to exercise by modeling what her brothers were doing. They would also play their games with her in the yard, so that her skills developed. As a teenager, she was able to attend regular class physical education with her peers, due to her advanced skill and fitness development. With Reyna, the social hook helped her maintain an active lifestyle and develop lifelong health behaviors.

As mentioned above, major stumbling blocks impede the fitness development of many children with developmental disabilities. Motivation is the primary problem. This raises the question of reinforcers. Obviously we want to stay away from food reinforcers, but social stimulation and activity reinforcers are excellent tools to developing motivation. The practice of involving peer participants is quite useful here. Also, if the child is enrolled in a workout program, which can offer stations, favorite activities [the more "active" the better] may be made available upon completion of portions of the workout. Above all commitment to fitness must be evident in the home environment - and communicating to the child that someone cares.