OK, now that I have time to sit down and actually think straight...
This whole thing with holding it together at school and falling apart at home.
Oh ya. SO familiar.
Like starting with grade 1.
I'm going to start by going out on a limb:
You should look at getting a more comprehensive evaluation.
Something that covers a broad range of territory... either by one person or team, or by several parts being done separately.
But you need to get to the bottom of whatever else is going on.
Because... what I suspect is happening is...
He is going to school, and trying really hard to be like everybody else.
He's waiting and watching what the others do, then copying their work to make his own (works at this age, catches up with them big-time later!).
He's pushing himself to mental exhaustion just trying to "listen", but doesn't quite catch it... then gets frustrated, because the teacher thinks he isn't trying.
He may be pushing himself to neuromotor exhaustion trying to keep up with the others on the playground and in PE class.
No matter what he does, he's behind the rest.
Yet, he knows he isn't stupid.
And he's smart enough to know that if he makes a major scene about this stuff at school, he's toast in the eyes of his peers.
But... as soon as he walks in the door at home, he's SAFE.
SO, he falls apart. Lashes out at YOU - when he's really lashing out at all that is happening at school.
Possibilities include... in NO particular order... and NOT exclusive from each other...
- Asperger's (not likely Autism Spectrum Disorders (ASD), but I'm no expert there)
- Developmental Coordination Disorder (DCD) (developmental coordination disorder)
- Auditory Processing Disorders (APD) (auditory processing disorders - there are multiple)
- hearing problems
- vision problems
- sensory issues
- learning disabilities
So. While there may be some form of tic disorder going on here, there's probably a whole raft of OTHER stressors.
Before you get too far into the medications thing... you need to know far more about what you are really dealing with.
THEN, you will be able to look at accommodations, interventions and medications.
And even then... some things will work, some won't, and as you resolve some issues, other stuff will show up that you didn't notice before.
Expect this to take multiple rounds...
But this first round is critical...
He's young enough for interventions such as Occupational Therapist (OT) and Speech Language Pathologist (SLP) to have MAJOR impacts (if called for, based on evaluation).
Getting the right - or even close to right - interventions, accommodations and medications NOW, definitely reduces the incidence and severity of secondary issues developing later (such as anxiety and depression and more).
Hearing and auditory usually starts with Speech Language Pathologist (SLP) evaluation.
Sensory and motor skills is usually an Occupational Therapist (OT) evaluation.
Everything else needs a neurypsych, or a child development/behavioural team, or equivalent... sometimes a team will include Occupational Therapist (OT) and/or Speech Language Pathologist (SLP), but it depends on the team.
Getting to the bottom of the "real" problems, usually has a major impact on the unwanted behaviors. They don't just magically disappear, because they become "habit", but there is no hope to address them until the "real" problems get addressed.