The book describes the worsening abuse that Pelzer suffered at the hand of his mother and her alcoholism. Most speculate that she had some other addiction or a chemical imbalance but none is known. Among the many incidents discussed is that his mother attempted to burn Dave on a stove when he was 8 years old. It was at this point his mother began to make him go without food for extended periods of time. The abuse gets worse and David is forced to sleep in the cellar and perform hard labor. He got an average of half a meal a day on a good day. When David was 10, she also stabbed him in the stomach—accidentally, as Pelzer notes in the book—and did not take him to the hospital (though she did take care of the wound herself). By this point he was no longer considered part of the family and lived in the basement, denied basic contact, play, and food. His mother stated that she did not want Dave to interact with "her family".
Over time the depth of the abuse worsened. Dave claimed he was forced to sit in the "prisoner of war" position (head bent backwards facing sky, sitting on hands). His mother stopped using his name and began referring to him first as "The Boy" and finally "It". The punishments are reported to have evolved into "sick games" in which she made her son suffer.
Incidents cited in the book include forcing ammonia down his throat, cleaning a sealed bathroom while inhaling the fumes from a bucket of ammonia mixed with bleach (Gas Chamber), inducing vomiting followed by forced ingestion, smashing his face against a mirror while forcing him to say "I'm a bad boy", beating him with a rubber hose, lying in the bathtub naked with freezing water for hours, rubbing his face in his baby brother's soiled diaper trying to make him eat his youngest brother's feces, as well as starvation and general malnutrition, and "accidentally" stabbing him with a knife when he didn't meet the time limit to do the dishes. His mother also put his hand on a gas stove which caused his hand to burn to crisp. She also sayed " Now sit on the stove so I can watch you burn and die."
In each of the sequels, the author reveals more forms of torture he did not describe in this book (e.g., his mother hitting his neck with a broom handle, causing his neck to swell so that he was unable to breathe).
Initially the abuse did not happen when his father was around. But when David entered first grade for the second time, the abuse began to occur even in his fathers' presence. At first he tried to stop the abuse but as time went on felt unable to intervene. David generally only got food when his father was home, for example. In the face of this abuse, his father gradually distanced himself from the house, and finally moved out when David turned 12. About two months later, on March 5th, 1973 David was rescued by teachers at his school.
Questions have been raised about Pelzer's works and their authenticity. In a 2002 New York Times article, "Dysfunction for Dollars," Pelzer's younger brother, Stephen Pelzer, is quoted as saying, "David wasn't at all ostracized from the family; he was very close to me and Richard. We were the Three Musketeers. David would make up lies, to receive some attention. But David had to be the center of attention. He was a hyper, over happy spoiled brat." Adding to the controversy, "his grandmother, Ruth Cole (born in 1910) remembers him as a 'disruptive kid, only interested in himself, with big ideas of grandeur.'"
Supporting Pelzer's story is schoolteacher Athena Konstan of Salt Lake City, who wrote, "In my 31 years of teaching, David Pelzer was the most severely abused child I have ever known."
Pelzer's website claims the book was nominated for the Pulitzer Prize; however, according to a recent Guardian profile, it was merely submitted to the prize board, a process open to any work of literature. It can therefore be considered a submission but not a nominee.