SYNOPSISThe purpose of the present study was to examine symptom configurations experienced by children with problem headache and to determine whether headache symptoms in children can be analyzed along a continuum of severity. Forty‐seven children between the ages of 8 and 17 years monitored their headache activity on a daily basis for a 3‐week period. The self‐observation data indicated that children did not show a tendency to experience their headache symptoms in terms of distinct muscle contraction and migraine symptom clusters. On the contrary, both categories of symptoms were observed to increase in frequency with increasingly problematic headaches. The presence of both muscle contraction and migraine symptoms increased in a linear fashion with the number of daily headache hours reported by the children during the self‐observation period. The measure of headache hours also correlated significantly with the total number of head pain locations and symptoms reported by the children. A regression analysis revealed that the symptom of nausea with the addition of the symptoms of dull and aching pain, bilateral forehead pain, feelings of tightness and pressure, and light sensitivity accounted for 77% of the variance associated with the severity measure of headache hours. Further support for viewing headaches in children in terms of severity came from an analysis of the time of onset of headache activity characteristic of the different children in the sample. Children with more severe headache activity experienced their attacks at an earlier time of day than children with less severe headache activity. Overall, the self‐observation data provided additional support for the severity model and supported the utility of extending the model to the study of headache disorders in