Patients with Tourette syndrome may experience significant behavioral, academic, social, and vocational difficulty. Early diagnosis and a comprehensive treatment plan which includes the school and family may prevent exacerbation of tic symptoms and behavior problems. Since the extent of impairment frequently is unrelated to the severity of any observed or reported tics, clinicians evaluating a child or adolescent who presents with tics or a history of tics should include assessment of family dynamics, a description of any school-based or peer problems, and an evaluation for motor deficits as well as determination of whether features of any associated or comorbid disorders are present. The clinician provides vital services as an educator and advocate for the patient and as a guide in directing the family and patient to available social, educational, and vocational resources.