These results indicate that interventions to increase the level of physical activity in children with and without ADHD might improve affect and executive functioning.

To date, the course of cognitive development in children after liver transplantation (Ltx) is poorly understood. Cognitive performance, however, is crucial in all developmental stages and for educational achievement. This cross‐sectional single‐center study examined the prevalence of long‐term cognitive impairment in a cohort of 64 pediatric patients after Ltx. Median age at Ltx was 12 months. The revised Wechsler Intelligence Scale IV was administered to assess cognitive performance. Patients were compared with an age‐ and gender‐matched group of children without a chronic health condition. Liver transplanted children performed significantly worse in three of four cognitive domains as well as in the Total Intelligence Quotient (Total IQ) (p = 0.017 to p = 0.005). Liver transplant recipients showed substantially more “serious delays” (IQ < 70) compared to the reference group (9.4% vs. 4.7%). Children with a genetic–metabolic disease performed worse than the other groups in three of the four WISC Indices and in the Total IQ (p = 0.05 to p = 0.01). The strongest association was revealed between height at Ltx and Verbal Comprehension (R2 = 0.21), Perceptual Reasoning (R2 = 0.30), Working Memory (R2 = 0.23) and Total IQ (R2 = 0.25). Our results indicate a high impact of primary diagnosis and height percentile at Ltx even on children's long‐term cognitive performance.

Results provide evidence suggesting that liver-transplanted children are at risk of developmental deficits regarding attention and executive functioning. Especially intrinsic alertness and working memory performance seem to be insufficient. This might result in deficient initiating, sustaining, and controlling of action. In summary, results demonstrate the need for an early and comprehensive developmental screening after pediatric liver transplantation.

Research on the association between physical activity and mental health addresses the beneficial effects of physical activity on emotional and cognitive functioning. With regard to emotional functioning, most studies focus on the influence of physical activity on depressive symptoms or affective disorders. These studies show that the beneficial effects of aerobic exercise and pharmacotherapy on depressive symptoms seem to be comparable and discuss a variety of neurobiological mechanisms that improve symptoms. The positive effects of physical activity on anxious mood and anxiety disorders are also well documented. Desensitization to physiological changes, improved self-esteem, and self-efficacy seem to play an important part. However, aerobic exercise does not improve mental health in every case, as seen for instance in over-trained athletes. Research on the relationship between physical activity and cognitive functioning reveals that physical activity can prevent the age-related cognitive decline and can delay the onset of dementia. Physical activity has beneficial effects not only on adults but also on children's and adolescents' mental health and cognitive performance, particularly on their executive functions that are still developing throughout adolescence. Finally, physical activity also affects the endocrine stress-regulation system: trained people reveal stronger reactivity and quicker regeneration when faced with stressful events.