Case: The 11-year-old boy was brought to the clinic by his mother, who was concerned that he was being bullied and teased at school. Born by Caesarean section after an 18 hour trial of labour, his early development was unremarkable. From the age of five years or possibly earlier, he was noticed to have unusual preoccupations. He was a poor mixer with other children, always standing alone in the playground and showing no aptitude for ball games.
Between the ages of seven and 10 years, he attended three schools and a further move brought the family to another city. He was consistently distressed by school, being the victim of bullying and teasing. He has always been articulate and is supercilious in his attitude to others, considering other children (and many adults) to be 'imbeciles and morons. He is of average intelligence only, but to hear him speak on his favourite topics suggests he…
