The assessment of handicap: an evaluation of the Environmental Status Scale.

The assessment and measurement of disability and handicap are of particular relevance in rehabilitation, as these are the main foci of therapeutic intervention. The area of handicap is the least developed with few measuring tools to provide an objective assessment of status. The Environmental Status Scale (ESS) is now becoming increasingly utilized to measure handicap. It was used in a study of 50 patients on admission and discharge in a neurorehabilitation unit, to analyse its validity and usefulness as an outcome measure of the rehabilitation process. The results suggest it has limited validity, mixes disability and handicap issues and in some sections has a misleading scoring system. It requires modification to overcome these difficulties.