In the initial months after Ava Layne Young's birth, she was unresponsive to sights and sounds and was so tiny she did not even register on the growth charts.
Ava, who was born prematurely, could barely swallow and she would not make eye contact with her worried mother, Ashley Young.
Doctors could not explain her lack of brain function and after carrying out MRIs, CT scans and blood tests, were about to diagnose her with some sort of genetic disorder when the tiny baby "woke up".
Since then, Ava has been making up for lost time.
The blonde four-year-old now competes in beauty pageants, even appearing on hit US reality show, Toddlers and Tiaras.
On the show, she can be seen donning tiny outfits and performing as a dog and a cowgirl.
She has won more than 100 pageant titles and has travelled to 11 states for the competitions.
"The best way to explain it is, she came alive," her mother said.
"She didn't start to really live her life until later. And now, she is definitely making up for it. Everyone notices. She's an attention seeker."
Ms Young, who lives in Georgia, said their tight-knit community and a prayer circle were the reasons behind Ava's recovery.