Alone in a Crowd

A 5-year-old boy is brought to the clinic by his mother due to concerns about his behaviour. At daycare, he isolates himself and does not engage with peers. He avoids eye contact, does not respond when his name is called, and rarely uses gestures to communicate. His mother reports repetitive rocking movements and significant distress when his routine is interrupted. His speech is limited, and he does not engage in imaginative or pretend play. He is unusually sensitive to loud noises and has an intense fixation with spinning objects.