- A widowed child psychologist lives an isolated existence in rural New England. Caught in a deadly winter storm, she must find a way to rescue a young boy before he disappears forever.
- Steven is a troubled kid from Maine being sent to boarding school. While his father, Richard Portman, is driving him there, they get into a bad argument, and the car swerves into oncoming traffic, killing Richard and putting Steven in a vegetative state. Six months later, Steven's stepmother, Mary, is taking care of him. Mary is a psychologist who works from home with children and adolescents. She is upset to learn that one of her patients, a deaf child named Tom, is to be transferred to a school in Boston. Later, Mary discusses Steven with her therapist, Dr. Wilson. While she feels guilty, she has decided to put Steven in a home to be cared for because he is unresponsive.
- The movie opens with Mary, a child psychologist who works from home, bidding farewell to her 18 year old stepson Stephen. His father, Richard, is taking him to a special school for the summer. Stephen is obviously very angry. On the way, he and his father get into an argument and Richard reminds him that he wasn't the one who got expelled. The car goes out of control and skids into the path of an oncoming truck.
Six months later, snow covers the grounds of the home where Mary and Stephen live. Richard was killed in the accident and Stephen was left paralyzed from the neck down. He cannot speak and is totally dependent on Mary for care. She dresses and feeds him, bathes him, and coaxes him to swallow his medication. Then she puts him in his wheelchair and leaves him in front of the television while she goes to her home office to see patients. But all this is taking its toll on Mary. Her stepson doesn't know it yet but she is planning to send him away at the end of the month.
One of Mary's patients is a little boy named Tom, who is hearing-impaired and mute. He has been in state care most of his life and his social worker, Joan, brings him to his appointments with Mary. Even though his behavior is violent and he resists Mary, she feels she can help him. But Joan informs her that this is her last session with Tom. He is being moved to a special school in Boston. Noticing that the child is not warmly dressed for a Maine winter, Mary gives him a knitted hat and scarf that once belonged to Stephen.
Mary Skypes with Dr. Wilson, the family physician. She is having trouble sleeping and Dr. Wilson wants to prescribe medication. To do that he needs a blood sample, which the home health care nurse will take care of on her next visit.
That night, Mary hears noises outside. She traces the source to a raccoon and laughs in relief. But suddenly there is a crash and the sound of breaking glass. To Mary's shock, she finds Tom hiding in her car, having broke a window to gain access. She brings him inside and goes into the next room to call Joan, offering to keep Tom for a few days. Suddenly the child runs outside and disappears into the woods. The temperature is well below freezing and he cannot survive long. So Mary calls the sheriff. A search of the woods reveals nothing, nor do subsequent searches reveal any trace of Tom. It is assumed he is dead from exposure or has somehow managed to leave the area.
The nurse comes to take a blood sample from Mary. Dr. Wilson will call her when the results are in. Meanwhile, Mary is having bizarre nightmares. She wakes to find Tom standing in her doorway before vanishing. Strange rattling sounds come from a crawlspace, but the opening is too small to admit Mary. She also dreams that Tom clamps his hand over her mouth and shushes her. Dr. Wilson feels these dreams are the result of extreme stress but Mary honestly believe she is seeing Tom's ghost. The doctor reminds her there are no such things as ghosts. Then Mary hears a news story reporting that a boy matching Tom's description has been picked up in Florida. It is thought he traveled there on a Greyhound bus. She is glad Tom is safe.
The father of one of Mary's patients, Doug, asks her to dinner. She thinks it would be wrong to go out with the father of a patient and also she doesn't want to leave Stephen alone that long. Since Doug doesn't know about Stephen, he is hurt by her rebuff.
An ice storm is coming and it is expected that power will be off for several days. Residents are advised to stock up on food, water, wood, and have lanterns available. Mary's secretary brings her some provisions and asks her to stay at their home. But Mary says she and Stephen will be fine by themselves.
Dr. Wilson Skypes Mary and he is very disappointed in her. Her blood tests show high levels of drugs that were prescribed for Stephen. She insists she has not taken the drugs but he doesn't believe her. At that point she signs off and leaves the room. Dr. Wilson then sees something unbelievable on the screen. Stephen walks by. In horror he realizes that Mary is in extreme danger. Despite the ice storm, he gets into his car and heads for Mary's house. He also calls the police to report the situation, but many people need help and they can't get to her right away.
The lanterns are padlocked inside a cabinet in the basement. Mary cannot find the key so she tries to break the lock with a hatchet. Doug drops by, having left his car down the road because Mary's driveway is blocked by piled-up snow. He has heard about Stephen's condition and understands why Mary can't leave him alone for long. He tells Mary that the news story concerning Tom was false. Mary tells him to show himself out as she is busy in the basement. She starts down the basement steps and realizes Doug could easily break the lock. She calls his name but the door closes and he is gone.
Just as Mary gains access to the lanterns and lights one, the power goes out. She is horrified to see Stephen in the shadows and starts screaming. He moves toward her and everything goes black.
When Mary awakens, she is bound, gagged, and in the bathtub. Stephen is soothingly talking to her, explaining that he had never been paralyzed but pretended to be because she took such good care of him. He has been spiking her tea with sleeping pills so he can move through the house at night. He found the brochures and knows she intends to send him away. But he can't allow that. Tom saw him walking after Mary brought him inside that night and he ran away in fright, but later returned. Stephen tried to kill him but the boy wriggled inside the crawlspace. It is he who caused the noises Mary was hearing, by banging on the walls.
Stephen accuses Mary of wanting to replace him with Tom. He loosens the gag long enough to force Mary to swallow pills. Mary pleads for her life and that of Tom, but Stephen intends to kill the boy. He replaces the gag and leaves.
Dr. Wilson arrives at the house and enters, but there is only silence. He calls out to Stephen that the police are on their way. Stephen finds the doctor and stabs him. He falls dying to the floor and Stephen props him up in the wheelchair. Tom is hiding on a closet shelf, too terrified to move. The sound of hammering is heard. Stephen is nailing the windows and doors shut.
Mary manages to get free and drinks shampoo so she will throw up the pills. Then she moves through the house looking for Stephen. She finds Dr. Wilson barely alive. He tells her not to dispute Stephen's fantasy and agree with everything he says. Mary tries to get out through the back door but something is blocking it. She manages to open it just enough to see Doug's body. Apparently Stephen murdered him hours earlier, just as he left the house.
Eventually Mary and Tom escape from the house and run toward the lake. Stephen follows. He captures Tom and is choking him when Mary picks up the hammer he threw down and kills him with it.
An unknown time later, Mary and Tom are shown driving to the child and family center. Joan has papers waiting for Mary's signature as she is adopting Tom. The luggage rack is filled with suitcases and boxes, indicating that the two are moving away for a fresh start.
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