The goal was to compare children with hemiplegia with those with diplegia within Gross Motor Functional Classification System (GMFCS) levels using multiple validated outcome tools. Specifically, we proposed that children with hemiplegia would have better gait and gross motor function within levels while upper extremity function would be poorer. Data were collected on 422 ambulatory children with cerebral palsy: 261 with diplegia and 161 with hemiplegia, across seven centers. Those with hemiplegia in each level performed significantly and consistently better on gait or lower extremity function and poorer on upper extremity and school function than those with diplegia. In GMFCS Level II, the group with hemiplegia walked faster (p=0.017), scored 6.6 points higher on Dimension E of the Gross Motor Function Measure (p=0.017), 6.7 points lower on Upper Extremity subscale of the Pediatric Outcomes Data Collection Instrument, and 9.1 points lower on WeeFIM self-care (p=0.002). Basing motor prognosis on GMFCS level alone may underestimate lower extremity skills of children with hemiplegia, and overestimate those of children with diplegia.

Does interstate competition reduce welfare generosity? Most analyses of this question focus on Aid to Families with Dependent Children (AFDC) benefit levels. The welfare-reducing logic of interstate competition should apply to all redistributive programs, however. We test for competitive effects more generally, examining several measures of welfare generosity for AFDC, Medicaid, and Supplemental Security Income-State (SSI-S) policy. We find evidence of interstate competition across multiple programs and measures over which states have authority. We also find variation in the effects that is consistent with variation in political debates across the programs.

The relationship between welfare benefit levels and the residential choices of the poor raises two issues for federalism in the United States. Do state benefit levels affect the residential choices of the poor? Do residential choices of the poor affect the level at which a state sets its benefit levels? Empirical studies have seldom studied the interconnection between these two issues. This research estimates simultaneously the mutual effects of welfare benefits and poverty rates while controlling for other economic and political variables. When benefit levels become high, the size of the poverty population increases. Conversely, when poverty rates become high, benefit levels are cut. The findings are consistent with the claim that state-determined benefit levels distort policy and residential choices.