A 10 year old female has not been submitting assignments, gr…
A 10 year old female has not been submitting assignments, grades have fallen and parents are concerned. The APRN notes frequent shoulder shrugging and eye blinking. The girl frequently clears her throat, grunts and sniffs, although mother says she does not have a cold and has been exhibiting these behaviors since age 8 and they tend to improve and then get worse again. The girl lifts a toy to her nose and sniffs it six or seven times during the interview. The child does not have a previous psychiatric history and has never taken medications. An appropriate diagnosis is