There's something wrong with Esther—and there has been for a very long time.

Empire has shared an exclusive clip of the upcoming Orphan: First Kill, and Esther (Isabelle Fuhrman) looks both as innocent and terrifying as ever under the flashing, red emergency lights of the psychiatric hospital. Innocent enough, in fact, that Anna (Gwendolyn Collins) doesn't believe she could be a patient, instead asking if her parents work in the ward.

Related: Orphan: First Kill: Plot, Cast, and Everything Else We Know

A prequel to 2009's Orphan, First Kill follows the sociopathic Esther—then known as Leena Klammer—as she orchestrates an escape from the psychiatric facility and makes her way to the United States by posing as Esther Albright, the missing daughter of a wealthy couple. As the thrill of reunification begins to wear off and her charade begins to crumble, the diabolical Esther finds herself pitted against sharp matriarch Tricia (Julia Stiles), who's determined to protect her family "no matter what."

Watch the full clip below:

'Never Been Done': Isabelle Fuhrman Talks Reprising Orphan Role

Isabelle Fuhrman as Esther in Orphan
Warner Bros. Pictures

2009's Orphan threw audiences everywhere for a thrilling loop with its unique twist: Esther, the strange-but-seemingly-sweet orphan adopted by a couple after a devastating stillbirth, is not actually a 9-year-old girl but a murderous adult woman with a rare hormonal disorder causing proportional dwarfism.

Fuhrman, who was ten years old when the first movie was filmed, spoke to Collider about reprising her role in the prequel. "There's never been an adult actress who reprised a role she played as a child. And that was exceptionally difficult and really fun to do, because when I was a kid and I played Esther, I was constantly playing a 33-year-old hiding herself as a kid while I was also 10, and this time, it was like, 'here's a little weight off my shoulders,' since I just have to pretend I'm 10, because I'm already an adult," the now 25-year-old said.

It was previously reported that CGI would not be used in Orphan: First Kill, instead using "old-school techniques" to make Fuhrman appear younger.

"For me it's like, we know the secret of the first film, so the fun of bringing Isabelle Fuhrman back into the role—which was a whole process to get approved—that is a challenge in and of itself," director William Brent Bell (The Boy 2) said. "And likewise, not doing modern CGI...I mean we use digital, we use CGI to help us...but not to create her at all. It's all old school techniques: forced perspective, camera angles, where we put the light."

Orphan: First Kill slashes its way into theaters on August 19.