He took the Praire State Exams and the ACT untimed. Even with that, he became very frustrated and gave up after 10 minutes. He seems ready to learn now, but is so behind. From 4th grade until now, his junior year,he was consumed with coping and learning how to deal with these conditions. The first possibility is increasing the dose of the patch.
Many clinicians think one patch per week is the maximum dose.
You should start with low doses and work up slowly. I understand both are due to insufficient dopamine levels although in different brain regions. While I occasionally see grandparents of ADHD and TS children with Parkinson's disease I do not believe it occurs more often than I would expect by chance. Parkinson's disease involves a deficiency of dopamine in the substantia nigra, while ADHD involves a deficency of dopamine in the frontal lobes, both distint regions of the brain. My recently TS-diagnosed 13 yr old boy says that he's been counting in his head, for a long time.