**_Slow slasher set in Savannah pays off with the last act_** A teacher of deaf kids is haunted by her upbringing with her crazy twin sister. When it’s discovered that she’s escaped the institution, people around her start dying. This builds up to the sisters’ birthday. While technically an Italian production, “Madhouse” (1981) was shot in America with American actors and is also known as “There Was a Little Girl.” While the first hour is mostly unhurried drama, this is the foundation for the crazy last act. The producer/director/writer Ovidio G. Assonitis gives hints of what’s really going on, but doesn’t spell it out. He respected the viewer to put the pieces together. The film should also be esteemed for featuring something that didn’t become in vogue until fifteen years later with “Scream,” although the contemporaneous “Just Before Dawn” did it as well. Meanwhile the ending borrows something from “The Night Strangler” from eight years prior. This was protagonist Trish Everly’s only proper film and starring role, which is strange since she’s a convincing actress. She happened to be a member of Dean Martin's singing/dancing group the Golddiggers from 1969-1971 and had bit parts in several TV series and a few TV movies. Her real name is Patricia Mickey. Also worth mentioning on the beauty front is blonde Morgan Most as Helen. Interestingly, James Cameron believed that Assonitis (listed as Oliver Hellman in the credits) would hire American directors to get funding from studios for his projects and then find an excuse to fire them and direct himself. The proof for this, it is claimed, is “Beyond the Door,” this movie, and “Piranha 2: The Spawning.” It runs 1 hour, 32 minutes, and was shot in Savannah, Georgia. GRADE: B-