This study examined the relationship between perception of communication and report of symptoms among second-generation Cambodian children and their parents using a matched-control design of clinic and community children. Children reported significantly higher symptoms than parents in both samples. Clinic parents reported more symptoms than community parents, but no differences were observed between children, and the mean level of child-reported symptoms was similar to past studies examining clinic populations. Parents reported better communication than children, and community respondents reported better communication than their clinic counterparts. Same-informant communication predicted symptom report. These data suggest that communication is a key factor in understanding symptoms in this group, provide evidence that child perception of communication is particularly important, and that the use of a matched control design might reveal high symptom levels in community samples that are otherwise undetected.