Art therapy (AT) is increasingly used to support the emotional, behavioral and social needs of children and adolescents facing psychosocial and neurodevelopmental challenges, yet evidence on how specific modalities, therapist roles and session structures contribute to outcomes remains fragmented. This systematic narrative review synthesizes findings from empirical studies on AT interventions for children aged 6–16 with Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), Intellectual Disability (ID) and Specific Learning Disorder (SLD). It aims to synthesize evidence on therapeutic mechanisms and modalities, examine the therapist's role in shaping psychosocial outcomes and identify methodological gaps for future research. Studies published between 2000 and 2025 were identified through database searches and reference screening, and data were analyzed thematically. Findings were organized into six themes: emotional regulation and expression, behavioral control and attention, social interaction and peer engagement, the therapist's facilitative role, art materials as therapeutic mediators and methodological/conceptual gaps in the literature. Across studies, AT was associated with improved emotional expression, attentional and behavioral control and social reciprocity, with therapist attunement and sensory engagement with materials identified as key mechanisms of change. However, the evidence base is limited by small sample sizes, inconsistent outcome measures, short intervention durations and underrepresentation of ADHD and ID populations relative to ASD. The review affirms the therapeutic potential of AT for neurodevelopmental populations while highlighting the need for larger randomized controlled trials, standardized measures and longitudinal designs to strengthen the evidence base and support integration of AT into school-based and clinical practice.

Keywords: Art therapy, psychosocial, neurodevelopmental, ADHD, ASD, ID, SLD, thematic

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