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it sure sounds like you little guy is having an extremely difficult time.  the neuro didn't have any better suggestions or medications to try & stop this tic~ing?

are you a stay at home mom who can homeschool him?  will he cooperate?  how long has he been on his medications?  could the concerta be the fly in the ointment?  sorry so many questions & not a real suggestion to give you.  

kris