Although the capacity of the immature nervous system to recover after injury is superior to that of the adult brain, children with cerebral palsy carry a great burden of morbidity for their entire life. Functional outcome may be determined not only by characteristics of the lesion (size, location, and timing) but also by the response of the brain to the lesion (cortical re-organization). Little is known about how underlying limitations, such as inefficient cortical re-organization, affect functional outcome and response to therapy in children with cerebral palsy. Because of this, individual rehabilitation strategies are based solely on the level of functioning rather than on the underlying impairment. Research demonstrates that novel rehabilitation strategies can manipulate plasticity of the motor cortex and, in this way, improve functional outcome in adults who have suffered a stroke. There is preliminary evidence that these treatments may also benefit patients with cerebral palsy. However, cortical re-organization after an injury to the developing brain may not be similar to that which occurs after a stroke in the adult brain. It would be of benefit to have a greater understanding of the impairments that arise from inefficient cortical re-organization in children with cerebral palsy. It is also important to have the research methodology to assess the effect of these novel treatments in order to measure their true benefit.