Research has linked family risk (FR) of reading difficulties (RD) with children's difficulties in emergent literacy development. This study is the first to apply parents' self‐report of RD as a proxy for FR in a large sample (n = 1171) in order to test group differences in children's emergent literacy. Emergent literacy, the home literacy environment and children's interest in literacy and letters were compared across different groups of FR children around the school entry. The FR children performed lower in emergent literacy compared with not‐FR children. Furthermore, when comparing FR children with one parent reporting RD and children with both parents reporting RD, moderate group differences were found in Emergent Literacy. Finally, parents' self‐report of RD was a significant contributor of emergent literacy after controlling for the home literacy environment, children's gender, their interest in literacy and letters, months in kindergarten, vocabulary and parents' education. Our findings suggest that schools should monitor the reading development of children with parents self‐reporting RD closely – especially if both parents self‐report RD. © 2017 The Authors. Dyslexia published by John Wiley & Sons Ltd.

It is well established that emergent literacy is a strong predictor of later reading difficulties, and that the home literacy environment plays an important role in the development of children's preschool emergent literacy and oral language. Furthermore, reading difficulties runs in families and children with a family risk of reading difficulties tend to show delays in emergent literacy and might experience a less advantageous home literacy environment. This study examined whether family risk predicts children's second-grade reading difficulties in a multifactorial model including both emergent literacy and environmental protective factors such as home literacy environment and parental level of education. Children were assessed for emergent literacy at the beginning of first grade, and were identified as having reading difficulties at the end of second grade if they performed below the national threshold in at least three of the subtests in reading and spelling. The multifactorial model suggested that children with family risk showed reading difficulties that could not be explained in terms of individual differences in emergent literacy, gender, interest in literacy, years in kindergarten, home literacy environment or parental education level. These findings highlight the advantages of using multifactorial models of reading difficulties that encompass different domains of genetic, cognitive-based and environmental factors. In sum, not only did we find family risk is associated with children's literacy outcomes after 2 years of formal reading instruction, but we also identified possible modifiable factors that may benefit from interventions and lessen the likelihood of developing reading difficulties.

BACKGROUND Adding pulsation to the Fontan circulation might change the fate of patients palliated by this procedure. Our aim was to compare the pulsatility index (PI) of the pulmonary artery (PA) between the various modifications of Fontan palliation. METHODS Doppler-derived PI was measured in PA branches of a cohort of 28 patients palliated by 6 modifications of Fontan procedure. A group of normal individuals was included for comparison. RESULTS Atriopulmonary connection (APC) group had the highest PA branches PI and statistically was close to the PI of the normal individuals (right pulmonary artery [RPA] PI of 1.58 vs. 1.63; p = 0.99 and left pulmonary artery [LPA] PI of 1.54 vs. 1.68; p = 0.46, respectively). The lowest PA branches PI was seen in the group of extracardiac total cavopulmonary connection (RPA PI of 0.62 and LPA PI of 0.65). Other 4 modifications including the extracardiac conduit with oversewn pulmonary valve, extracardiac conduit with preserved adjusted antegrade flow, extracardiac conduit from inferior vena cava onto the rudimentary right ventricle and lateral tunnel had a mean “RPA and LPA” PI of “1.19 and 1.17”, “1.16 and 1.11”, “1.13 and 1.11”, “0.82 and 0.84”, respectively. The modified Dunnett's post hoc test has shown a significant statistical decline in PI of all modifications compared to the normal individuals except for the APC group. CONCLUSIONS Fontan palliated patients in different groups of surgical modification showed a spectrum of Doppler-derived PI with the highest amounts belong to the groups of pulsatile Fontan.