Classify the tics by type and duration, and screen for comorbid ADHD and OCD, as these comorbidities often cause more functional impairment than the tics themselves.

Tic disorder classification depends on duration (provisional <1 year, persistent >1 year), type (motor only, vocal only, or combined for Tourette's), and functional impact. At 3 months with both motor and vocal tics, the current diagnosis would be provisional tic disorder. The most critical assessment beyond the tics themselves is screening for comorbid ADHD (comorbid in a majority of children with tic disorders) and OCD (comorbid in a substantial minority), which are present in the majority of Tourette's cases and often require treatment before the tics do. Many mild tic disorders require only monitoring, psychoeducation, and reassurance.

Diagnose Tourette's disorder and start an alpha-2 agonist, as the combination of multiple motor tics and a vocal tic with stress-related fluctuation meets the diagnostic criteria for Tourette's.

Tourette's disorder requires tics for >1 year with onset before age 18. At 3 months, the diagnosis is provisional tic disorder, and many provisional tics resolve without treatment.

Attribute the throat clearing to allergies and refer to an allergist, as vocal symptoms in a 6-year-old are more commonly related to upper respiratory or allergic conditions than to a primary tic disorder.

Throat clearing in the context of concurrent motor tics (eye blinking, shoulder shrugging) and stress-related fluctuation is a vocal tic, not an allergic symptom. The pattern of multiple motor and vocal symptoms co-occurring points to a tic disorder.

Start a stimulant trial for ADHD, as the repetitive movements and stress-related behavioral changes suggest underlying ADHD-related restlessness and dysregulation rather than a primary tic disorder.

The movements described are tics (brief, repetitive, stereotyped), not the fidgeting or restlessness of ADHD. While ADHD should be screened for as a comorbidity, initiating a stimulant without assessment could potentially exacerbate tics.