Before the advent of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (American Psychiatric Association 2013), child psychiatrists in Taiwan tended to diagnose children with normal or even high intelligence quotient (IQ) social disorders such as Asperger’s disease, highfunctioning autism, and atypical autism by phenotype only, which ignored the nature of the disease and the etiology of the corresponding brain block. The symptoms of mental illness may have different causes that lead to similar manifestations. This case report describes a child’s cognitive and psychological aspects and disease appearance following drug treatment. Although the DSM-5 (American Psychiatric Association 2013) defines the diagnostic criteria of Tourette’s disorder (TD) as the presence of motor and vocal tics for more than one year, TD may be misdiagnosed as its symptoms tend to vary in severity over time and present differently (Cavanna & Seri 2013). TD also has comorbidities such as attention-deficit/ hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD)/trait, autism, and learning disorder (Robertson 2015, Cravedi et al. 2017). The stereotyped or repetitive behaviors of autism and tics can be confusing. Motor tics can be mistaken as a sign of autism. Unless the patient has obvious blinking, facial tics, vocal tics, etc., the probability of misdiagnosis is quite high. Hence, we propose this case as a living example.
