Avoid anything written by Jack Ketchum. Not everything that is told in the book is true. Jack Ketchum exaggerated and made many things up in his own head. For example, he added more and nastier sexual violence than actually happened. A sane person doesn't invent such things and add them to the story of a real murdered child. The book is more a fantasy of a sick person than a description of a real event. Sylvia Likens was real person who was brutally abused and killed. Her fate didn't deserve to be turned into torture porn novel.