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Motor vehicle accidents (MVAs) are one of the most common types of trauma experienced in this country. Recent studies have reported that approximately 30% to 50% of adult victims of MVAs experience severe and lingering distress following moderate to severe accidents. The present study examined the effects of MVAs on non-head-injured school-aged children. There were three main goals for the present study: (a) assess child MVA victims for general and accident-specific distress in comparison with a NonMVA sample, (b) assess the utility and initial reliability of a modified accident severity questionnaire, and (c) explore possible variables that might account for the range of distress reported by MVA children. Fourteen MVA children and 38 NonMVA children were assessed with a variety of self- and parent-report measures of accident-specific and general distress measures. MVA children did report higher levels of accident-specific distress, consistent with the levels of distress reported in other accident and trauma studies. There were no differences between the MVA and NonMVA children on self-report measures of general distress, nor on a standardized parent-report of behavior problems. On a broad diagnostic interview, parents of MVA children reported higher numbers of symptoms for their children compared with those of NonMVA children. Results from this study supported the utility of a comprehensive perceived accident severity measure for children. Parent and child agreement on this measure was strong, and the measure was highly correlated with child-reported distress, suggesting good initial reliability and validity of this new measure. Due to the limited sample size, the prediction model could not be tested in the present study. An ongoing study by the present investigator and colleagues will allow for more complex analysis of the questions presented here as larger sample sizes and a broader range of MVA severity data becomes available.