An five year old male exhibits frequent shoulder shrugging,…
An five year old male exhibits frequent shoulder shrugging, eye blinking and some facial grimaces. He often clears his throat, grunts and sniffs. Mother says he has been exhibiting some of these behaviors since age 4, and they often improve and then get worse again. The child smells a number of different objects during the interview. The child does not have any previous psychiatric history and is medication naive. First line treatment recommendations based on guidelines is