Liam, 12-year-old male Patient: Liam, 12-year-old male Presenting Concerns: Frequent involuntary movements and vocalizations for the past year. Mother reports Liam makes sudden shoulder jerks and occasionally blurts out words. Symptoms worsen with stress. History: No substance use. No significant medical history. Provider Notes: Diagnosed with Tourette's disorder. Discussing medication options and behavioral interventions. What characteristics define this diagnosis?

A. Vocal tics only: Tourette’s disorder requires the presence of both motor and vocal tics. Vocal tics alone are insufficient for this diagnosis, though they may occur alongside motor tics. B. Obsessive handwashing: Repetitive handwashing is a compulsive behavior associated with obsessive-compulsive disorder (OCD), not a defining feature of Tourette’s disorder. While comorbidity is possible, it does not define the diagnosis. C. Persistent depressed mood: Depressed mood may occur as a comorbid condition but is not a core diagnostic criterion for Tourette’s disorder. The disorder is characterized by tics rather than mood disturbance. D. Motor tics and vocal tics: The presence of multiple motor tics (e.g., shoulder jerks) and at least one vocal tic (e.g., word blurting) persisting for over a year meets the diagnostic criteria for Tourette’s disorder. Symptoms often fluctuate in severity and may worsen with stress.