This film is based on a true case. In 1965, teenage Sylvia Likens was beaten, starved, and taunted by her former neighborhood friends and by her caregiver. While her sister survived, Sylvia died from all the trauma and the case was brought to trial, raising awareness of child abuse and bullying.
Jack Ketchum chose to write the book from the first-person perspective of the neighbor because the real case had some things he was mortified with that he didn't want to include.
In the backyard tent scene where the boys are looking at the "Playboy" magazine, they refer to 1950s actress and pinup girl Carroll Baker, the real-life mother of actress Blanche Baker, who portrays Ruth Chandler in this movie.
"The most wearing scene? All the scenes in which I am hung up and blindfolded," asserts Blythe Auffarth. "It's extremely humiliating and it's a little bit scary being so without control. It's scary being helpless and it's humiliating hanging and dangling there, and it's even more petrifying to have your senses taken away from you. I actually was blindfolded and I couldn't see, and so you're relying on your ability to hear and also trust those around you and the ways in which they deal with you. ... That wasn't anything that was acting--that was pure torture, no pun intended."
Jack Ketchum: the author of the book on which this film is based appears as the carnival ticket-taker.