Once a diagnosis is established, a comprehensive surveillance plan needs to be developed. This largely depends on the underlying syndrome but is influenced by the types of polyps found during the colonoscopy, as well as the behavior of the disease in other affected family members. While information about family history of the disease is important, the impact of modifier genes and environmental factors can cause variations within the same family. Once a consensus has been reached on the best strategy for surveillance, it is important to minimize any sense of helplessness and inevitability that will affect the patient's compliance to surveillance. It is also very important to prepare the child for any unpleasant aspects of their surveillance and to choose the least invasive and upsetting method available.