5 yr old boy with Social and other issues

[two at a time]

We have a 5 yr old boy who is often in his own world as far as other children are concerned. Because he and his sister (twins) have no one their age in our family, we have had them in play groups since they were about 1 1/2. He has been in pre school for 3 yrs and will start kindergarten in the fall. He would rather play by himself or with grown ups than with other children. He also tends not to listen to his teachers unless they are a bit forceful with him (giving him no choice), and reacts very negatively to other children making any kind of noise around him..like when on the playground. When he hears children being loud or a baby cry he freaks out, sometimes screaming, or sometimes telling that they are wrong. But yet he sometimes like to be loud himself.
When we try to get him to participate in organized activities, he appears selfish, whines, and is very disruptive to the rest of the group, often requiring an instructor or coach to give him extra attention. He doesn't listen fully to their instruction, and dwells on things which do not matter to the task at hand. He often does not "fit in" with the rest of the crowd and is always an outsider, and has no real friends. The other boys and girls try to be friendly to him, but he just ignores them. He prefers to be with grown ups.
On the bright side, he is intelligent (not yet in kindergarten and can read very well, do simple addition and subtraction, and loves to spell.  Sometimes we must curtail his constant quest to spell words), polite (always says please and thank you, and asks to be excused from the dinner table), and has a drive to be nice. Sometimes his drive to be nice is too much. When he has a meltdown because of noise by other children, he cries, apologizes, and says that he wants to be nice. He then tells us that he loves us, and we always tell him we love him, regardless of his behavior.
He also may have some compulsive activities, as he constantly is spelling, and looking at numbers on clocks or timers.
He has seen an occupational therapist, but it does not seem to help.
What can I do?

[Kevin Kennedy, Ph.D.]

Was the involvement of OT due to concern about possible sensory integration disorder, manifested by sensitivity to sound? It may be that your son's presentation is typical of developmental immaturity, but it could also be a sign of emotional disorder(s). Theis should be evaluated, and it would be wise to arrange an evaluation with a child psychologist.