The real-life daughter, Paula Baniszewski, was released from prison and changed her name. She ended up getting a job as a guidance counselor aide in an Iowa school and worked there for 14 years before anyone found out about her real past. She was immediately fired.
This movie was the second attempt to tell Sylvia Likens' story on the big screen and the first one to be successful. In the early 1980s there were moves to make a movie about Sylvia but they were dropped in the face of intense opposition from Sylvia's sister Jenny. It wasn't until after Jenny's death in 2004 that efforts to tell the events of 1965 in a movie were revived.
The film was shot in chronological order to give the actors the experience of what Sylvia really went through.
Catherine Keener originally turned down the role of Gertrude Baniszewski, however after she couldn't get the story out of her head she met with director Tommy O'Haver and agreed to do the film.
The film is based largely on actual court transcripts from the case.