We took my son to a psychologist for anxiety in K. I had thought it might be overkill but it was a huge help.

Also check for tick diseases along with strep. Both can be underlying and hard to diagnose underlying causes of tics and all sorts of mental and neuro/behavioral changes. Doctors however are often unaware or skeptical but when such behaviors magically reduce/disappear when kid has a course of antibiotics sometimes the puzzle pieces fall into place.

He is not involved in any extracurricular activities. I think the constant worksheets aren't helping. Also, the teacher seems very driven, type a. He begs to stay home, which he never did in preschool.