Developmental follow-up, surveillance and support at the age of 4 years: a best practice guide from the British Association for Neonatal Neurodevelopmental Follow-Up.

Developmental follow-up is a necessary part of neonatal care to identify additional support needs but also to allow national surveillance and research. Follow-up at 4 years of age enables assessment before school entry, allowing schools to be ready for and support children and their families. This is not currently routine across the UK despite the National Institute for Health and Care Excellence recommendations in 2017. This best practice guide was developed by the British Association for Neonatal Neurodevelopmental Follow-Up, a special interest group of the British Association of Perinatal Medicine.This framework supports clinicians developing and delivering a 4-year developmental follow-up service for children whose neonatal experiences put them at risk of developmental conditions or additional learning needs. This should include as a minimum those born before 28 weeks' gestation and infants with moderate to severe neonatal encephalopathy. Infants with risk factors for developmental problems should also be considered.This framework recommends assessment of developmental domains including physical development and growth, cognitive development, emotional and behavioural development, sensory needs, speech, language and communication skills, social skills and relationships. A summary report should be shared with caregivers and key individuals in health, education and social care. This should describe the child's strengths and needs to support transition into and throughout education.Specific service arrangements will vary depending on local resources and existing services. This framework provides guidance for clinical teams to enhance follow-up for children whose early experiences put them at risk of challenges, facilitating lifelong learning, participation and well-being.