This Christmas, Marlisa Smith has to choose between paying the bills or getting a little something for her three girls.

Smith worries most about not keeping up with daughter Ashley’s medical bills; they’ve been accumulating since she was born with a severe brain abnormality, mental retardation and autism seven years ago.

Her boyfriend was injured on the job a few weeks ago and worker’s compensation has yet to kick in. He’s the sole breadwinner of the family, and there’s not much in their savings account. Smith can’t work outside the home because she always needs to be on stand-by for Ashley if she has breathing problems or other emergencies.

She also is heavily involved in her daughter’s school and doctor/therapy appointments, and has to take care of her baby girl.

The Adopt-A-Family program, run by Helping Hands Hawaii, can help families struggling through a rough patch by providing a bit of Christmas cheer. The public can designate their funds or donated goods to a certain family in need through the Star-Advertiser’s annual Good Neighbor Fund.

Household supplies, toys and clothing can be dropped off at the agency’s Community Clearinghouse, or arrangements can be made for large items to be picked up.

Ashley has microcephaly — an abnormally small brain — that would make her unable to crawl, sit up, or walk on her own, according to a doctor’s diagnosis. The disorder also affected her daughter’s body — her facial features are small, and she looks more like she is 4 years old instead of 7 — Smith said, and she has braces on her legs.

Smith said she refused to believe her daughter would grow up to be as helpless as the neurologist described.

"I had faith that if I pushed hard enough, I could prove that (diagnosis) wrong." Even if the outcome wasn’t what Smith wanted, "at least I know I tried," she said, adding, "If I didn’t, I wouldn’t know how far she could have gone."

"I built a team (of therapists) for Ashley with a lot of hard work and tears, not stopping, even though some days it felt like nothing was helping," said Smith, who called everywhere, determined to get every bit of help possible from public health nurses, and occupational, physical and speech therapists.

"I am proud to say Ashley is a very active and smart little girl. She loves running and playing ball, loves swimming and splashing water, loves to read along by pointing to words that we point to, as we read to her." Ashley cannot hold a pencil, but can do puzzles and other lessons on an iPad her school provides, she added.

Smith left a relationship on Maui in 2007 with the father of Ashley and her eldest daughter, Sierra. She lived in a Waianae transitional housing project for a while.

"I had to be a mom, dad, everything to my girls," she recalled. "I knew I couldn’t give up on them. I had to show my daughter Sierra, you gotta just keep going in life."

Sierra — now 13, and a straight-A, active student at Waianae Intermediate School — has "played a big role in helping me" carry out the exercises suggested by therapists, Smith added.

Boyfriend Mikala Molina entered their lives about three years ago, knowing the difficulties she had with Ashley and being a single mother.

"From the start he fell in love with the girls and saw something special in them immediately. Working side by side with us to help Ashley, she learned to walk" after age 4. The couple then had Mikayla, now 2, who teaches Ashley what the toddler is also learning. Ashley loves the music Molina plays on the ukulele; he sings to her every day.

"We are fortunate to have all we have even if it may not seem like much to others. We have our health, a roof over our heads, and food on the table. During the holiday season it’s a little hard for us to provide what we wish we could for our babies. I wish I could give them so much, especially for working so hard and not giving up, for loving each other, for striving together as a family," Smith said.

Ashley has outgrown her toddler bed, which Smith would gladly exchange for a twin bed anyone donates. As a member of an All-Stars after-school softball team, Sierra needs a large stainless-steel flask or a gift card from Sports Authority. Smith is also washing cars to raise money for Sierra’s school trip next year to San Diego to compete with other members of the Jr. Searider Television program.