So that "Caty First" ethot was a fake after all. Compare the belly moles, and the bed in the background, with this other ethot called "Sasha Blessingson".
Pretty clever work from whoever resold her pictures. I have heard of people doing that before; there are some ethots with Down's syndrome but nearly all of them are fake, made by a 3rd party taking normal ethot's pictures and putting a filter over them.