9-year old boy has an 18-month history of involuntary movements of the face,
neck and upper extremities. He has a poor attention span and over the past
few months has developed compulsive hand washing.
PMH: No medical illnesses. He has normal motor and language development. He was held back and repeated first grade due to immature behavior and poor progress.
Family History: Father was labeled as “hyperactive” in school and did not complete high school.
Social History: He is an only child and lives with his parents who are both unemployed.