Objective of the study is to investigate the possibilities for developing the subject specific actions of preschool children with mental development disabilities (MDD) in the context of targeted motor play activities in a special differentiated and inclusive education environment, as well as in medical and rehabilitation organisations. Methods and structure of the study. The study involved 350 preschoolers with MDD aged 4 to 7 years, including 40 children receiving palliative care in a hospice setting. The formative experiment was conducted using a methodological complex of 28 specially designed game tasks using adaptive physical culture tools – exercises aimed at developing specific actions in the context of game activities with the participation of a physical education and adaptive physical culture instructor, a speech therapist, and a teacher-psychologist. Results and conclusions. It has been established that the conditions of an inclusive educational institution are most favourable for the development of motor game actions in preschool children with MDD, provided that early (from 4 years of age) and systematic corrective and developmental intervention is provided. A positive correlation was found between the indicators of the level of mastery of subject-specific actions, the quality of plot-based play, and communication skills, which demonstrates the importance of the systematic implementation of motor game programmes in solving the tasks of corrective and developmental work. © 2026, Teoriya i praktika fizicheskoy kul'tury i sporta. All rights reserved.