You mentioned symptoms of Tourette Syndrome (TS), which is our BTD(oing)T experience. You may want to keep the TS piece in mind as you seek to better understand what is going on for your DD. Children with TS frequently experience other neurodevelopmental and neuropsychiatric conditions, including ADHD http://www.cdc.gov/ncbddd/tourette/data.html and handwriting difficulties https://www.tourette.org/resource/handwriting-issues/. In our experience, management of TS included a neuropsychological evaluation to explore questions related to co-occuring conditions, including attention deficit. I�m NOT saying that your DD has TS but given the constellation of concerns you raised it may be a question to at least frame and explore with your pedi and/or specialists.