Young children account for approximately 50 percent of all pediatric burn victims, yet relatively little research has focused on posttraumatic stress disorder (PSTD) symptoms among these young children. The current study hypothesized that the size of the burn, the level of pain, and the parents’ acute stress symptoms would relate to the child’s symptoms of acute stress. Participants were 52 parents of children between the ages of 12 to 48 months who were recruited from the Shriners Burns Hospital-Boston. Questionnaire data were gathered from parents pertaining to child symptoms of PTSD and acute stress reactions. Medical information about the children pertaining to pulse rate and level of pain was gathered from the primary nurses. Results of statistical analyses including path analysis indicated that 29 percent of the sample had acute stress symptoms. Two independent paths to these acute stress symptoms were identified: (1) from the size of the burn to the child’s pulse rate to acute stress symptoms, and (2) from the level of pain to the parents’ acute distress to the child’s acute stress symptoms. Clinical implications of the findings are discussed and include the observation that the identified risk factors for acute stress symptoms in child burn victims offers opportunities for targeted interventions. Tables, figure, references