I've got a nearly 9 year old and obviously interact with all his little friends, when they come on play dates. In addition I work in education. From what we see, Alfie is years apart from a typical boy of that age.
His speach is far away from his peers of the same age, he clearly has delayed / atypical language development (his queen's English accent, his lisps and his inability to make a sentence flow (like he's always thinking hard for the next word as he's saying it and then has difficulty saying it too - it makes the sentence hard to follow and disjointed).
He stims, his body movement and movement flow isnt typical, he appears very socially awkward, his facial features just aren't quite right, he's got vision problems and he was born with cardiac issues.
I'm my limited opinion, I'd say Aspergers or a syndrome
He needs help and support whatever it is (and it is something, she can't keep pretending because it's just making her look like she's ignoring it and being negligent at this point).