 Lately, he's been practicing his name. It's an outward-facing fist stroking one cheek. It stands for Sam Giggles, which he does a lot. Sam lives in a small town, so we're only using first names in this story, since he and his siblings are minors, and we want to freely discuss Sam's disabilities. Once Sam is done with his morning routine of nebulizers and medications, he signs the word BALL to tell his mom he's ready for his favorite activity.