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Selecting meaningful functional outcomes for child health evaluative research amidst a scarcity of fit-for-purpose measures is a persistent dilemma. Functional measures assess a child’s physical functioning, for example, mobility or self-care activities. In this viewpoint, we will integrate current discourses with our experience as child health researchers in the context of selecting patient-important outcomes and related measures for a large, allied health cluster randomised controlled trial (RCT). The CHESS (CHildren’s Early Self-care Support) trial, funded by the NIHR Health Technology Assessment programme, seeks to evaluate the effectiveness and cost-effectiveness of an allied health intervention to support self-care in young children (1–4 years and 6 months) with neurodisability. 1 This discussion sits within the widely agreed enduring uncertainty about what constitutes meaningful trial outcomes, for whom, in what circumstances and how best to measure them.2