Angela was first referred to the clinic when she was twenty-five months old. When she attended the health centre for a routine developmental check-up, her mother complained that Angela was presenting increasing difficulties with her eating. The community paediatrician wrote:

Angela has an eating problem. She survives on numerous snacks during the day and will only take a couple of mouthfuls of food at meal times. Mother says that she has tried various approaches to try and get Angela to eat at meal times. This problem started at around nine months of age and has not improved. Angela has managed, in spite of all this, to sustain good weight gain, remaining just above the fiftieth centile since the age of nine months. My impression is that her mother is a sensible person and she does seem to have approached this problem in a reasonable manner.

100An appointment was sent to Mrs A, but she failed to attend. We spoke to the referring doctor and the family’s health visitor and we were told that it might be best not to pursue the referral at that point. One year later, Angela was referred again. The general practitioner told us that Angela, now just over three years old, had an eye test some months earlier; she was shown a picture of a fly and since then had developed a severe “fly phobia” and was terrified of seeing them. She would cry and “pinch herself, refusing to go into any room until she is reassured that there are no flies there”.