ABSTRACT

Objective : This study systematically reviewed the effects of structured play-based interventions on executive function in children with developmental disabilities and summarized their relevance to occupational therapy. Methods : Experimental studies published from January 2016 to May 2026 were searched in domestic and international databases. Nineteen studies met the inclusion criteria. Data were analyzed using the Participants, Intervention, Comparison, Outcome framework. Levels of evidence were classified using the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence. Risk of bias was assessed using Risk of Bias 2 for randomized studies and Risk of Bias Assessment tool for Non-randomized Studies 2 for nonrandomized and single-group studies. Results : Eleven studies were Level II, three Level III, and five Level IV. Interventions included digital games, movement and sports games, rhythmic and music games, structured and peer play, and cognitive flexibility training. Positive changes were reported in working memory, inhibitory control, cognitive flexibility, self-regulation, and attention, although some effects were limited or unclear between groups. Conclusion : Structured play-based interventions may support executive function in children with developmental disabilities. However, heterogeneity across diagnoses, interventions, outcome measures, and study designs limits generalizability. Further occupational therapy–based research is needed.