Before the clinical detail: this is a child who had already been through more medicine in four years than most people meet in a lifetime — and a family carrying the weight of all of it.
His story starts early and hard. A urinary tract infection at three weeks. Sepsis at five weeks — hospitalisation, IV antibiotics, lumbar punctures. A congenital solitary kidney, laryngomalacia, recurrent airway and ENT problems, immune vulnerability with low T-cell counts, and a childhood of recurrent infection that meant prolonged antibiotic exposure. A 16p11.2 chromosomal microdeletion was identified at eighteen months, autism at two and a half. By four, he was globally delayed by around two years, with severe speech delay and a body that had never thrived.
Feeding was the daily front line. He would push a full plate away entirely; his accepted diet had narrowed to a handful of foods. Sensory sensitivity — to textures, to dirt — had intensified over the previous year, tightening the circle further. He was under a full NHS multidisciplinary team: paediatrics, ENT, immunology, endocrinology, nephrology and neurology, with fortnightly speech and language therapy and weekly occupational therapy. Every one of those teams was doing important work within its remit.
What his parents were looking for was different, and specific. Not a replacement for any of that care — it continued throughout. They wanted someone to investigate the terrain underneath: the gut, the nutritional status, the immune picture, the reasons a child could be eating so little and communicating so little at once. They wanted the whole child on one page. That is where functional investigation begins.