A study evaluated the effects of the Empowering Steps Movement Therapy (ESMT™), a personalized physical activity program, on children and youth with neurodevelopmental and/or intellectual disabilities. Conducted over 12 months with 42 participants, the study assessed changes in motor skills, social and leisure adaptive skills, home and community participation, and quality of life. Results indicated a small but consistent improvement in motor skills, averaging 0.17 points per month. Autistic children showed slightly higher gains. Positive trends were also noted in community and home participation, while improvements in social adaptive skills were minimal, and there was a slight decline in leisure adaptive skills and quality of life. Factors such as parental education and socioeconomic status were analyzed, revealing their potential impact on outcomes. The type of neurodevelopmental condition significantly influenced both motor and social adaptive skills. Although the sample size was small, the study suggests that tailored, individualized physical activity programs may lead to meaningful improvements for children with these disabilities. Further research with larger samples is needed to validate these findings and encourage the adoption of such personalized approaches in therapeutic settings.