It sounds like he does better socially when there is a good degree of structure and
routineRoutine sputum culture, and in more uinstructured situations his emotions get the better of him. This warrants an evaluation by a pediatric behavioral health professional; that is what I'd advise. Re: the fighting between him and his brother, I'd place the onus on both of them to stop it. If any altercation occurs, I'd ground them both so there will be mutual interest in refraining from fighting. Competitive is one thing; fighting is another.