There is increased recognition that children who survive very and extreme prematurity have a spectrum of behavioral adaptive, and social challenges. This vulnerability requires both ongoing surveillance so as to guide families in the management of feeding, sleep, play, communication, discipline, and learning. This cannot be solely done by health professionals alone, but by explicit community partnership supports that promote exploration, curiosity, interaction, and learning. If neonatal centers of excellence combine developmental surveillance, family support, and community partnerships, then we will be better able to understand the complexity of developmental and behavioral outcomes. This will lead us to understand the pathways of risk and resiliency.