The need to adapt the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV, American Psychiatric Association, 1994) criteria for diagnosing posttraumatic stress disorder (PTSD) in young children is widely recognized, yet attempts to validate alternative criteria have been limited. We examined profiles of PTSD symptoms in 29 Israeli children directly exposed to terrorism and a comparison group of 25 unexposed children. Whereas only 7% of the exposed children met PTSD criteria according to the DSM, an additional 24% were identified using the alternative criteria adopted in the revised diagnostic classification of 0 to 3. None of the children in the comparison group met criteria for diagnosis. Significant associations between exposure variables and PTSD supported the validity of the alternative criteria.