In cases involving these issues, the process of determining child competence varies widely as a function of both the case context and the willingness of the court to consider psychological input. Assessment of competency or incompetency revolves around four basic elements: the ability to understand information on the consequence of the decision to be made, the ability to manifest a decision, the manner in which the decision is made, and the nature of the resulting decision. These elements involve psychological aspects of comprehension, autonomy, assertiveness, reasoning, anticipation of future events, and judgments in the face of uncertainty or contingencies. Many aspects of human development inhibit or enhance competency and the ability to give informed consent. These include socialization and pressure to conform, time perspective, and the ability to manipulate concepts. Because children are generally regarded as incompetent per se, adults often are called upon to provide proxy consent or substituted judgment for the child. In cases involving conflicts between children's and parents' rights, courts have held children's rights to be paramount or have terminated parental rights. Specific areas in which child competency and consent are important issues include consent to treatment, criminal or delinquency actions, child custody decisionmaking, and certain civil litigation. Psychological and developmental research provides a means for answering legal questions about child competency. 68 references.