I think IMHO he sounds like a young man who would do very well in a structured home something like 'Bethany', which they had in the town where dh had his practice.
SGC, you don't mention the sister. How is she doing? I have the feeling that she isn't the 'handful' that her brother is.....yet. Am I guessing right?
He did a great job on that quilt. It just tells me that with constant supervision he can accomplish everyday tasks very well. Life will definitely be an uphill climb for that boy but if he has somebody pushing him along he can reach the top and succeed.