There are a surprising number of instances of smoking shown, typically in front of Cece (the main character). Cece’s mom smokes (and appears to drink wine at one point). We see even more smoking when mom makes a new friend. Cece catches her sister smoking (who threatens her if she tells). We see a whole room of teachers smoking in the break room, one of a few instances of this (even worse, one teacher tells another a student is “making my life hell!”, to which 1st grade Cece laughs). We don’t see any place where this is shown as wrong.

There is a big focus on watching TV, seemingly unmonitored by parents. Cece seemingly watches all types of TV even as a really young child (mentions soap opera, sitcoms, dramas). The saddest part of this comes when Cece says that the only time she can spend time with her older siblings is watching TV.

At one point dad takes her to movies with subtitles after she loses her hearing. Leaving he says, “I’m not sure these movies are all appropriate for you… that was a lot of skin”.

Early on there is a bit of heaviness as little 4-year-old Cece gets really sick all of a sudden and has to go to the hospital. This is shown in a decent bit of detail to show the seriousness of it. She ends up losing her hearing, which is obviously traumatic.

Early on when Cece comes home from the hospital she remarks, “Miracle of miracles, my siblings are being nice to me” (a heartbreaking comment revolving around a very common secular view of how families function).

The main character gets nude or mostly nude a few times (e.g., when changing). The illustration style showing the characters as not exactly human-looking makes this not come across as nudity normally would, but good to know it is there to weigh for your reader. A new friend tells Cece to look down her shirt and spell “attic”, with the book spelling out the inappropriate result. Later we see Cece thinking that a friend’s dad is “dreamy”.

There is quite a bit of focus on her crush on a neighborhood boy. He says he wants to use her hearing aid microphone for ‘fun’ at school. Cece thinks it “sounds like trouble” and doesn’t want to, but then says, “but for Mike Miller I’d do anything” (a terrible comment to put in front of young children). The result? While they are supposed to be doing silent math with the teacher out of the room uses Cece and her microphone to spy on the teacher, holding a mini-party in the room. Once Cece hears her coming back (again from smoking) in the microphone they all sit and pretend they were working. Worst off, this is never shown as wrong. In fact, the opposite happens, with Cece glowing at the attention she is getting from her classmates, very proud of her deception.

Other parts of the book to be aware of:

At 4 years old Cece is shown drawing on her mother’s mirror with lipstick and watching Batman on TV.

There is a place in the story where Cece gets rude and even kicks her mother (out of place with most of her behavior).

There are multiple images of a character vomiting. We also see an image early on of Cece getting a shot in the spine. Later she runs into a tree and pokes her eye with blood shown.

There is quite a bit of focus around sleepovers, which many Christian parents are wary or at least cautious of. At one point we see a group of girls sneaking into the host’s brother’s bedroom.

We see references to Monty Python, Van Halen and the Beatles.

We see the following words/phrases: dumb, stupid, butt, ‘holy hearing aid Batman’ and holy cow. A group of girl scouts get together and sing songs where potty terms are repeated over and over. A teacher is reading a story and says, “His flesh is rotting off those mean bones, and maggots are creeping in his eye sockets and crawling out his nose holes”.