Common difficulties encountered by patients with pediatric traumatic brain injuries (referred to hereafter as pediatric TBI patients) were identified, and the congruence between caregiver and professional perceptions of these problems was examined. Forty-seven caregivers identified 118 obstacles experienced in the care of their pediatric TBI patients. Another sample of 46 caregivers cross-validated these problems by rating each for its frequency and difficulty. Items were rank ordered by their composite score, a derived measure obtained for each item by cross-multiplying the frequency and difficulty ratings. Twenty psychologists who work with pediatric TBI patients also rated each of the 118 problem situations. A modest correlation (tau = .28, p<.001) between the two groups' rank orders of the problem situations, although significant, suggests that there are discrepancies between caregiver and professional perceptions of problem situations. Items perceived as most common and difficult by caregivers often received far lower ratings by psychologists and vice versa. The results suggest that carefully evaluating individual patient concerns may contribute to more efficient use of professional resources and improved patient education and follow-up care.