In this episode of SLP Coffee Talk, Hallie chats with Libby Hill, a consultant speech-language pathologist with over 40 years of experience, about the fascinating connection between pathological demand avoidance (PDA) and selective mutism. Libby shares why students with PDA aren’t just being “naughty,” how their brilliant yet challenging language profiles can fool us into expecting too much, and why creating the right environment is everything. You’ll learn practical strategies like the “projects on pause folder” and why traditional therapy goals need to flip the script to focus on what the team needs to do, not what the student needs to fix. Whether you’re hearing about PDA for the first time or looking to deepen your understanding, this episode reminds us that sometimes the best therapy plan is building rapport and following the student’s lead.​​​​​​​​​​​​​​​​

Bullet Points to Discuss: 

• How a rain-soaked TV appearance opened the door to specializing in PDA
• Key differences between PDA and autism with extreme demand avoidance
• The connection between pathological demand avoidance and selective mutism
• Why environment and relationship-building matter more than direct goals
• Practical strategies like the “projects on pause folder” and flexible choices
• How to support students without triggering demand avoidance​​​​​​​​​​​​​​​​

Here’s what we learned: 

• PDA and selective mutism? They’re more connected than you think.
• Getting the environment right beats direct intervention every time.
• Flexibility and choice look different for every student.
• Try the “projects on pause folder” - it removes pressure and sparks curiosity.
• Build rapport without an agenda, and watch progress happen.
• The right diagnosis matters - wrong strategies can do more harm than good.​​​​​​​​​​​​​​​​

Learn more about Libby Hill: 

Website: www.smalltalk-ltd.co.uk

Facebook: https://www.facebook.com/smalltalkspeechandlanguagetherapy 

Let’s Talk Small Talk Podcast: https://letstalksmalltalk.transistor.fm 

Learn more about Hallie Sherman and SLP Elevate:  

📝 Website: https://speechtimefun.com/

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