hood. New-onset abnormal move ments suggestive of tics out side of the us ual age range
should result in evaluation for other move ment disorders or for specific etiologies.
Tic symptoms cannot be  attributable to the physiologica l effects of a substance or an-
other medical condition (Criterion D). When there is strong eviden ce from the history,
physical examination, and/or laboratory resu lts to suggest a plausible, proximal, and
probable cause for a tic disorder, a diagnosis of other specified tic disorder should be used.
Having previously met diagnostic criteria fo r Tourette’s disorder negates a possible di-
agnosis of persistent (chronic) motor or vocal ti c disorder (Criterion E). Similarly, a previ-
ous diagnosis of persistent (chronic) motor or vocal tic disorder negates a diagnosis of
provisional tic disorder or ot her specified or unspecified tic disorder (Criterion E).