Importantly, coprolalia is an abrupt, sharp ba rk or grunt utterance and lacks the prosody
of similar inappropriate speech observed in human interactions.
The presence of motor and/or vocal tics varies across the four tic disorders (Criterion
A). For Tourette’s disorder, both motor and vo cal tics must be present, whereas for per-
sistent (chronic) motor or vocal tic disorder, on ly motor or only vocal tics are present. For
provisional tic disorder, motor and/or vocal tics may be presen t. For other specified or un-
specified tic disorders, the movement disorder symptoms are best characterized as tics but
are atypical in presentation or age at onset, or have a known etiology.
The 1-year minimum duration criterion (Cri terion B) assures that individuals diag-
nosed with either Tourette’s disorder or pe rsistent (chronic) moto r or vocal tic disorder
have had persistent symptoms. Tics wax and wa ne in severity, and some individuals may
have tic-free periods of weeks to months; ho wever, an individual who has had tic symp-
toms of greater than 1 year’s duration since fi rst tic onset would be considered to have per-
sistent symptoms regardless of duration of ti c-free periods. For an individual with motor
and/or vocal tics of less than 1 year since firs t tic onset, a provisional tic disorder diagnosis
can be considered. There is no duration specif ication for other specif ied and unspecified tic
disorders. The onset of tics mu st occur prior to age 18 year s (Criterion C). Tic disorders
typically begin in the prepubertal period, with  an average age at onset between 4 and 6
years, and with the incidence of new-onset tic disorders decreasing in the teen years. New