Thanks for the reply, Chemar.
If Jim did subsequently post about his physicians, I'm afraid my google-fu is not strong enough to find it.
Syracuse does seem too far, especially since my understanding is that multiple follow-up visits are typically needed when you work with an environmental doc.
I will cross-post in the ADHD board, thanks for the suggestion.
Regarding my DS's tics, I will add a few more details regarding his stimulant meds. His baseline tic is an infrequent yelping sound, not very noticeable. Amusingly (?), I realized last year that his uncle has had the exact same tic his whole life, but I had never consciously noticed it as such!
Anyway, during the recent holiday season, the tics became very much more frequent, and began to be accompanied by a hand gesture. A possible med trigger for this is that about this time we switched him from brand Ritalin LA to generic methylphenidate ER. However, other candidate triggers are holiday food indiscretions, holiday excitement, and winter weather.
We switched back to the brand med, and the food indiscretions and excitement have subsided. (Winter weather has persisted.) In the two months since the onset, his tics have become less frequent, but are still significantly higher than his old baseline.
I would be interested in hearing if anyone has noticed tic triggers from generic ritalin versus the brand med.