I think he’s just a classical INTJ personality — and it’s obvious his home is abusive, at least emotionally (if not physically) which is undoubtedly a big part of his behaviour.

It would make sense that Patrick has a unique problem with expression, ironically because he’s so good at manipulation now.
Around 4, we develop “Theory Of mind.”, the understanding that others have different thoughts and don’t know what we know (Google the “Smarties” test if you’d like, but short version: If you say, have a box that says it’s candy, they’ll think it’s candy. But they open it up, and nope, it’s got buttons in it. Now if you close the box and ask them again what’s in it, they’ll know it’s buttons. But then you ask them what their mom in another room would say if we showed her the box: The child who doesn’t have a Theory of Mind yet will say buttons, they know, so mom knows.). Theory of mind helps us form empathic accuracy, amongst other things. When we understand others don’t know what we are thinking, and vice versa, we have to start looking for ways to determine what they are thinking, and we have to be able to make clear what we are thinking.
Patrick would inevitably have arrested development on this: He in fact does know what others are thinking. Until he grew older and the value of manipulation would occur to him, he would have far less need to develop empathic accuracy naturally: You don’t need to learn to read other’s body language when they will tell you they are angry/happy/sad before they are even in the same room as you. You’d never need to look for signs somebody is not being truthful because they have never been anything but 100$% truthful all the time (Lies would be especially confusing I imagine, why would anybody lie when you’d immediately know it’s not true? It has no value beyond “being silly” games you might play with a toddler, right?). Because adults especially can read children in ways they don’t realize, Patrick would understand he was doing something that was upsetting the adults but would probably take longer then you’d think to realize the extent of how different he was. I mean, Dad knew when he was in pain when he limped inside after tripping on that rock, mom knew when he was angry at her even though he didn’t say anything… doesn’t everybody know what other people are thinking?
Of course, as we see in this page, he would eventually develop Theory of mind, but he did it for entirely different reasons then the rest of us, and learned how to express himself as a one-way expression of intent and emotion rather then an essential part of two-way communication like the rest of the world.

He hasn’t just found out; he’s in ongoing shock. The spiralling mindset above is more like a picture of the thoughts that race through his mind every time he interacts with his child, showing Patrick the huge ambivalent tear between what his father wants to feel (ie. love, pride, closeness) and what he’s actually still feeling (panic, frustration, fear, desperation, helplessness). Having a serious and unresolved home issue like this can wear on the mind constantly until you’re left with deep mental channels carved by that slow erosion.

My initial guess on reading this was that the parents have known there’s something not quite right about Patrick for a while, but since none of the other anomalies have shown up yet, the doctors took a while to get to the diagnosis of “can read minds.” It’s not something that would be the first guess if you’re not in a world where superhumans are already a thing.

She can, because she’s reviewing Patrick’s memories. He could “hear it” so anybody experiencing it can to.

1. Patrick’s powers are CREEPY. look at that ‘dinner table’ conversation.. tell more than 10% of the worlds population would be able to converse with the kid Patrick behaving like that and not be extremely uncomfortable at least. look at what he told the doctor. Remember that for Patrick this is normal.. he hasn’t figured out that hes the only one doing this yet.
2. Alison’s powers though extreme are understandable. helping her grow up to be a useful member of society just needs a few extra conversations (for example: Alison, if you use your full strength to grip… you can crush cars.. you are going to need to be calm and think about what you are about to do)
3. when the doctors and other ‘learned’ people do not know what to do they get creative. yes a secret pedophile is the last person who should be studying children but they don’t know how far down perversion hes gone yet. sadly that often looks like abuse… what do mechanically inclined children do with clever mechanisms… they take them apart to see how they work. what makes you think the doctors are any better?

You have a good point, but motives matter here – Alison’s parents didn’t do all of the above as a means of enriching themselves or forwarding their agenda, which it seems Claudia may well have done. While rather abhorrent, the option Geoff and Susan selected was the least bad of a bunch of pretty awful options. It may very well be that the scientists we see here aren’t the same agency Alison got to deal with – this may be an agency utterly unrelated to that one (covert agency versus military agency, for example). Different missions usually mean different methods. Remember, the CIA did the “enhanced interrogation techniques”; the military just handed them over to be “techniqued” (And yes, both are reprehensible acts).

One can take the situation differently – Alison’s parents saw sociopathic biodynamics threatening the material and conceptual fabric of society and endangering the lives millions. After talking with their daughter, they elected to allow their daughter to volunteer to participate in a plan to stop that, the only apparently viable plan on the table. After those scientists carefully determined the limits of her anomaly (determining that very little could harm her physically) and after they provided her with martial and tactical training to minimize the risk into which Alison was sent, Alison chose to heroically placed her life on the line to minimize loss of life and property damage in the face of unprecedented situations. That same agency also provided continuing health & anomaly monitoring and regular counseling to minimize her combat trauma.

Same situation, different viewpoint.