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The purposes of this qualitative study were to describe behaviors of infants and toddlers when in acute pain and to describe changes in those behaviors across the 3-yr span. With the use of naturalistic observation, 32 children, birth to 36 mo of age, were observed following surgery, fractures, or burns. Purposeful sampling of children, who were inpatients of a private midwestern hospital, was used. Data sources included child observations, parent interviews, and patient records. The research method used was grounded theory. Three pain behavior categories were developed, and characteristics of each category were identified. Pain categories included motor movement, communication, and facial expression. Theoretic implications were proposed. It is concluded that predictable changes in pain behaviors occur within infancy and toddlerhood. A matrix of pain behavior is presented.