The findings indicate that many children and their parents do not share the same view of the child's reaction in the aftermath of an acute injury. Parent--child agreement was low regarding the presence and overall severity of child acute stress reactions. The study identified an important source of potential bias in parental reports on their children. Results clearly show that parents' own reactions following their child's injury can influence their assessment of their child's symptoms. This suggests that clinicians should obtain child self-reports of acute stress disorder whenever possible. They should also take into account parent symptoms of ASD when interpreting parent reports. Parent--hild pairs (n=219) were assessed within 1 month of a child's injury. Parent--child agreement was examined regarding the presence of acute stress disorder in the child, as well as its severity and specific symptoms. 4 tables, 1 figure, and 34 references