She is unable to walk, crawl, stand or even sit unaided.
But four-year-old Bethany Smith is the proud artist behind a Christmas card on sale for East Anglia's Children's Hospices.
Bethany, who has a neuromuscular condition and is supported by Each, painted a reindeer design for the charity's official Christmas cards.
She is also prone to chest infections and has to use an overnight ventilator to protect her chest.
She spends six nights a year at Each's Quidenham hospice and gets 12 hours of care a month at her Cringleford home.
Her mother Caroline said: 'We're extremely proud of Bethany's artwork being chosen for the Each Christmas card.
'The home services we receive are so beneficial to us all, as is the time spent at Quidenham as a family.'
The Smith family, which also includes father Steven and sisters Bonnie, Adele and Karen, spend quality time with Bethany on their visits to the hospice.
'Bethany and her sisters do all sorts of things from making frozen castles, painting, arts and crafts to treasure hunts and lots more,' said Mrs Smith. 'It allows us as parents some quiet time to relax and also spend time together as a family with activities we can all do.
'We can't put into words how much of a difference Each makes to our family.
'The team there are absolutely fantastic and have included Bethany in so many different events and activities, we can all see her confidence and independence has grown.'
Bethany's card will be sold along with other designs from Each children and seven traditional cards.
Each head of retail Gabrielle Spray said: 'Bethany's 'Hands up!' reindeer card is just one example of the creative work EACH does.
'We're thrilled that Bethany's card is available to buy and I'm sure it will sell really well so we can continue to support local children and families. '
You can buy packs of 10 for £3.50 from all Each shops, Cards For Good Causes venues and the Haddenham Galleries near Ely.
Do you know an inspiring child we should feature? Email polly.grice@archant.co.uk
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