New directions in the outcome evaluation of children with cerebral palsy.

This article addresses newly emerging concepts regarding the examination of outcomes in children with cerebral palsy (CP). Three important factors have prompted a change toward a broader approach to outcome measurement: (1) the recent endorsement of the World Health Organization classification scheme of functioning, disability, and health; (2) recognition of the importance of the role of child and environmental factors in modifying outcome; and (3) appreciation of the challenges faced at key transitions during development. Comparison of the literature on outcomes in children with CP published in 2002 with studies published 10 years earlier demonstrates an increased number of studies and a wider range of outcome measures used to characterize the functioning of these children. A better understanding of the extent and nature of the outcomes and their determinants is critical to guide clinical decision making and program planning to maximize community integration, social participation, and overall well-being of the child and family.