Updated by Kyle Hummel, AA, and Kate McKenna, MEd, MSEd, MS, BCBA
Association for Science in Autism Treatment

Description: LeGoff Lego®-Based Therapy

The purpose of this treatment summary is to examine the research related to Lego®-Based Therapy as developed by Daniel LeGoff (2004). Created in the early 2000’s, Lego®-Based Therapy was designed as a play-based intervention (Narzisi, 2021) that would provide individuals with autism opportunities for social interactions within a natural play activity using materials of interest to them (LeGoff, 2004). Research studies using LeGoff’s protocol have been implemented with children and teenagers between the ages of six and sixteen years old who are diagnosed with autism spectrum disorder (ASD). The goal of the protocol is to structure Lego building sessions to provide multiple opportunities for sustained conversation, problem solving, and joint attention, thus making the sessions as interactive as possible. Skills frequently targeted in Lego®-Based Therapy interventions include initiating play, responding to questions or comments from others, turn taking in games and in conversation, and referential communication, the ability to describe an object, image, or event to convey meaning to the audience. Other forms of “Lego therapy” have been trialed in the research; however, LeGoff’s protocol has been the only one studied extensively and, therefore, will be the focus of this treatment summary.

Lego®-Based Therapy can help individuals develop social and communication-based skills, such as turn taking, asking for help, and making eye contact (LeGoff, 2004; LeGoff & Sherman, 2006; Owens et al., 2008; Levy & Dunsmuir, 2020). By participating in this therapy, children may also acquire fine motor skills, which include reaching and grasping various Lego bricks, locking the bricks together, and taking the project apart, one brick at a time. Furthermore, students may show improvements in visual perceptual motor skills, which encompasses following a diagram to build a project, correctly aligning the bricks, and matching bricks by size, shape, or color (Brosnan, 1998).

Research

The protocol for implementing Lego-based Therapy has been clearly described by LeGoff in multiple sources (LeGoff, 2004; LeGoff & Sherman, 2014, LeGoff et al., 2014; LeGoff, 2017). Participants engage in building with Lego sets, taking on one of three specified roles, or jobs. The first of these roles includes the engineer, who reads and gives instructions to the other participants. The second role is the supplier, who finds the correct Lego bricks to use. Third is the builder, who constructs the model based on the directions of the engineer and pieces given by the supplier. Neither the supplier nor the builder sees the direction booklet. Participants take turns fulfilling the roles. An adult, either a teacher, clinician, or parent, functions as a director who assists participants, as needed.

Lego®-Based Therapy has been conducted in schools (Levy & Dunsmuir, 2020), at participants’ homes with parents serving as the supervising adults (Peckett et al., (2016), and in clinical settings (LeGoff, 2004; LeGoff & Sherman, 2006; MacCormack, 2015). Ages of participants have ranged from 3 to 16 years (Narzisi, 2021). Reviews of the research on Lego®-Based Therapy have revealed that an overwhelming number of participants were male (Narzisi, 2021).

Currently published studies involving the use of Lego bricks, either in a packaged set or with assorted bricks in a container, are inconsistent in their use of the bricks and the social skills intervention methods used with them. Lindsay et al., (2017) conducted a review of 15 studies using Lego bricks published between 1996-2016. While they found that 14 of the 15 studies reported improvements in social and communication skills, there were differences in treatment protocols across studies that made it difficult to evaluate the effectiveness of the therapy. Broadly, the authors expressed concern that available studies did not use randomized control groups and standardized measures of behavior.

Narzisi et al. (2021) reviewed 19 studies, published from 2004 to 2020, that examined the effectiveness of LeGoff’s Lego®-Based Therapy. Improvements in social skills (MacCormack et al., 2015) collaborative behavior (Huskens et al, 2015) and increases in the frequency of social initiations (Levy & Dunsmuir, 2020) were the most consistently reported result of the intervention. The authors noted that the flexibility of the Lego®-Based Therapy results in ease of application across environments of home, school, and clinical settings. However, 12 of the studies had neither a control group nor reliable definitions of social skills, making it difficult to state with certainty that the Lego-based intervention was responsible for improvements in social skills. Additionally, there was variability in the number of treatment sessions across the studies, ranging from 3 to 51. Measurement of behavior change primarily came from video observations, interviews, and questionnaires, the subjective nature of which reduces the reliability of the studies. The authors stated that the research did not support a rating of evidenced based. Additionally, it is important to note that Lego®-Based Therapy was not included in any task force reports such as the National Standards Project (2015) or the National Clearinghouse on Autism Evidence & Practice report, Evidence-Based Practices for Children, Youth, and Young Adults with Autism (2020).

Recommendations

Research studies are needed that include randomized control groups, consistent definitions of the social skills being investigated, and standardized measures of behavior. Should Lego®-based therapy be shown to be evidence-based based on the results of more rigorously designed research, future studies could examine other questions. For example, future research could explore the efficacy of the LeGoff protocol on individuals of different ages and a variety of settings. Research thus far has been predominately limited to male participants; therefore, evaluations with female participants are needed. Additionally, validated methods for teaching adults to implement the intervention are needed. Lastly, there has been no research examining the relationship between skill development and the role (engineer, supplier, builder) the participant is playing in the session, or the optimal protocol for switching roles across sessions.

Providers interested in using this method should be very transparent about the state of the science when recommending this therapy.

The findings of the research, despite showing positive results, should be viewed with caution. Both reviews conducted on Lego®-Based Therapy indicated that more research is warranted and cautioned against identifying Lego®-Based Therapy as evidenced based (Lindsay et al. 2017; Narzisi et al., 2021). Building with Lego bricks may be an enjoyable leisure activity for autistic individuals during which they can interact with others. However, claims that intervention protocols that include Lego bricks can produce positive and sustained improvements in social skills lack research validation at this time.

Selected References

Systematic Reviews of Scientific Studies:

Lindsay, S., Hounsell, K. G., & Celia Cassiani (2017). A scoping review of the role of LEGO® therapy for improving inclusion and social skills among children and youth with autism. Disability and Health Journal, 10, 173-182.

Narzisi, A., Sesso, G., Berloffa, S., Fantozzi, P., Muccio, R., Valente, E., Viglione, V., Villafranca, A., Milone, A., Masi, G. (2021). Could you give me the blue brick? LEGO®-Based therapy as a social development program for children with autism spectrum disorder: A systematic review. Brain Sciences, 11(6). https://doi.org/10.3390/brainsci11060702

Task Force Findings:

National Autism Center. (2015). Findings and conclusions: National Standards Project, phase 2. Author.

Steinbrenner, J. R., Hume, K., Odom, S. L., Morin, K. L., Nowell, S. W., Tomaszewski, B., Szendrey, S., McIntyre, N. S., Yücesoy-Özkan, S., & Savage, M. N. (2020). Evidence-based practices for children, youth, and young adults with Autism. The University of North Carolina at Chapel Hill, Frank Porter Graham Child Development Institute, National Clearinghouse on Autism Evidence and Practice Review Team.

Selected Scientific Studies:

Brosnan, M. J. (1998). Spatial ability in children’s play with Lego blocks. Perceptual and Motor Skills, 87(1), 19-28. https://doi.org/10.2466/pms.1998.87.1.19

Huskens, B., Palmen, A., Werff, M., Lourens, T., & Barakova, E. (2015). Improving collaborative play between children with Autism Spectrum Disorders and their siblings: The effectiveness of a robot-mediated intervention based on Lego therapy. Journal of Autism & Developmental Disorders, 45(11), 3746–3755.

Lee, G. T., Jiang, Y., & Hu, X. (2023) Improving social interactions for young children on the autism spectrum through parent-mediated LEGO play activities. Remedial and Special Education 44(6), 457-468.

LeGoff, D. B. (2004). Use of LEGO© as a therapeutic medium for improving social competence. Journal of Autism and Developmental Disorders, 35(5), 557-571.

LeGoff, D. B., & Sherman, M. (2006). Long-term outcome of social skills intervention based on interactive LEGO© play. Autism, 10(4), 317-329.

Levy, J., & Dunsmuir, S. (2020). Lego therapy: Building social skills for adolescents with an autism spectrum disorder. Educational & Child Psychology, 37(1), 58-83.

MacCormack, J. W. H., Matheson, I. A., & Hutchinson, N. L. (2015). An exploration of a community-based LEGO® social-skills program for youth with autism spectrum disorders. Exceptionality Education International, 25(3), 13-32.

Owens, G., Granader, Y., Humphrey, A., & Baron-Cohen, S. (2008). Lego® therapy and the Social Use of Language Programme: An evaluation of two social skills interventions for children with high functioning autism and Asperger syndrome. Journal of Autism and Developmental Disorders, 38, 1944-1957.

Peckett, H., MacCallum, F., & Knibbs, J. (2016). Maternal experience of Lego therapy in families with children with autism spectrum conditions: What is the impact on family relationships. Autism 20(7), 879-887.

Other References:

LeGoff, D. B., Gomez de la Questa, G., Krauss, G. W., & Baron-Cohen, S. (2014). LEGO®-based therapy: How to build social competence through LEGO®-based clubs for children with autism and related conditions. Jessica Kingsley Publishers.

LeGoff, D. B. (2017). How Lego®-based therapy for autism works. Jessica Kingsley Publishers

Citation for this article:

Hummel, K., & McKenna, K. (2024). A treatment summary of Lego®-Based Therapy. Science in Autism Treatment, (21)2.

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