Taking care of three boys is already a challenge for most people, more so when all three have or are suspected of having autism.
Madam Annette Chua, 33, does just that - and two of the boys are not her sons but her nephews.
For going "over and beyond her duty as an aunt", she was one of five people to receive the Exemplary Caregiver's Award last month from Club Rainbow, a charity that supports chronically ill children and their families.
She is the primary caregiver for her nephews, aged seven and six, as their parents have mental illnesses and marital problems. Both boys have autism and are beneficiaries of Club Rainbow.
People with autism have difficulties in social interaction and communication, among other things.
Her two-year-old son, Jeryl Foo, is suspected of having autism too, but has not been formally diagnosed as he is very young, she said.
When The Straits Times visited her and the boys last Thursday in her four-room flat in Punggol, they initially behaved like boys their age, sitting on a sofa and watching a cartoon show on television.
I don't want them to follow in their parents' footsteps. I want to give them the family warmth, rather than having them go through anxiety, which might lead to some psychological problems when they grow up.
MADAM ANNETTE CHUA, on why she chose to take care of her nephews, who have autism. The boys' parents have mental illnesses.
But the challenge of caring for them was evident later, when they did not sit still and look at the camera during the photo shoot, and when they often interrupted the 1½-hour interview, sometimes shouting for attention.
Madam Chua, whose husband works in communications, has been taking care of her nephews since they were born, with some help from her parents. Her brother, two years her junior, is her sole sibling. He and his wife were diagnosed with mental illnesses before their sons were diagnosed with autism.
Asked why she chose to take care of her nephews, Madam Chua said firmly: "I don't want them to follow in their parents' footsteps.
"I want to give them the family warmth, rather than having them go through anxiety, which might lead to some psychological problems when they grow up."
Club Rainbow executive director Jerome Yuen said: "Annette's conviction despite her circumstances is one of the compelling reasons she was bestowed the Exemplary Caregiver's Award. She has gone over and beyond her duty as an aunt."
Madam Chua quit her job as a supply chain executive in a manufacturing firm in December 2013, when pregnant with Jeryl, as she had some health problems then and also wanted to spend more time taking care of her nephews.
She attends seminars and reads up online on early intervention, and has started creating her own educational materials to better coach her nephews and son.
In April, she started a support group on Facebook, called "Children with Learning Disabilities Support Group - Singapore", for parents of children with special needs. It has more than 150 members.
Starting the support group, on top of caring for her nephews and son, shows how far she has come.
When her son was suspected of having autism, it hit her hard. "I was quarrelling with my mum, saying that we need to do this and that to help him, if not his future will be like this and that," she said.
"I was concerned about how my son and nephews would be independent in future... their educational pathways... and what can they do in the future."
She also struggled with anxiety and depression from 2010 till last year. Said Madam Chua: "I kept asking myself: 'Why am I getting all this?' It was overwhelming. I had to handle (the boys). I had to juggle issues with my brother and sister-in-law. I was very exhausted."
It was only last year that she decided to focus more on the children, instead of helping her brother and sister-in-law with their marital problems. She also said turning to religion last year helped her.
"I don't feel so stressed now and I don't see the need to manage problems that I can't solve," she said.
A poster in her home also encourages her during tough times - it cites a Bible verse from Psalm 55: "Cast your cares on the Lord and he will sustain you; he will never let the righteous be shaken."
Now, she cares for her nephews mainly on weekends and during school and public holidays.
Her younger nephew is in full-day childcare and the older one is in primary school and goes for after-school student care; their grandmother takes them from school to her home in Jurong on weekdays.
Caring for them as an aunt, instead of as a mother, had posed some unique challenges, such as when finding pre-schools for them.
"I said my nephews' parents had some psychological issues; it is already stated in (the boys') diagnostic assessment reports. Some pre-schools rejected us outright...
"They said: 'We are very particular about our children's safety. We don't want your brother and sister-in-law coming to the centre to pick up their children; we can't stop them. What if they act up and harm other children?'"
Madam Chua and her husband are considering applying for legal guardianship of her nephews.
She has asked herself whether she has given her son the same attention as her nephews, but she tries to "balance it out".
She said: "When I was pregnant with Jeryl, I was already worrying about whether he would be able to get along with his cousins...
"But my worries (were) unfounded. They get along very well and bond like real siblings, and that puts my heart at peace."