The mother of a 9-year-old boy explains to the PMHNP that he has a 6-month history of excessive eye blinking and grunting, and he recently began persistently clearing his throat. What is the most likely diagnosis?

Choice A reason: Temporary tic disorder involves motor or vocal tics lasting less than 12 months. This patient’s symptoms have persisted for 6 months and include both motor and vocal tics, making a simple temporary tic diagnosis less appropriate. Choice B reason: This is the correct answer. Tourette's disorder requires both multiple motor tics and at least one vocal tic, present for more than 1 year, starting before age 18. The boy’s presentation of motor and vocal tics over a 6-month period suggests early diagnosis of Tourette’s disorder if symptoms continue beyond a year. Choice C reason: Persistent (chronic) vocal tic disorder involves only vocal tics for more than 1 year, not combined motor and vocal tics. Choice D reason: Provisional tic disorder is diagnosed when tics are present for less than 1 year. Since the boy has both motor and vocal tics and duration may approach 6–12 months, this may be considered but does not fully explain the combination of tics if they persist beyond a year.