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

Reviewed by:
Kate McKenna, MEd, MSEd, MS, BCBA, LBA

Why research this topic?

Research Synopses: Adults with AutismCore deficits of autism include difficulty with social interactions and forming friendships. Individuals on the autism spectrum typically struggle with social relationships and play skills. Skills frequently in targeted in social skills interventions include initiating play, responding to questions or comments from others, turn taking in games and in conversation, and referential communication (Lindsay et al., 2017; Narzisi et al., 2021).

Lego-bricks are often a preferred play activity for children on the autism spectrum (LeGoff, 2004; LeGoff & Sherman, 2006). Researchers have examined the use of Lego-bricks as a potential material for use in interventions targeting social skills in individuals with autism spectrum disorder (Peckett et al., 2016; LeGoff, 2004; LeGoff & Sherman, 2006; Lindsay et al., 2017; Lee et al., 2023). The authors of the above studies describe a set of consistent procedures that were implemented during social groups. Building with the Lego set to complete the structure is a group activity in which there are three roles or jobs that require individuals to work together to complete the steps in the directions; the engineer who gives verbal descriptions of the pieces to be used in each step and directions for the assembly, the supplier who identifies the needed pieces and gives them to the builder, who then follows the verbal descriptions given by the engineer to build each successive step of the structure. Neither the supplier nor the builder see the instructions. Participants take turns fulfilling the three roles. An adult facilitator works with the group as needed to encourage communication, engagement. The goal of the protocol is to make the building session as interactive as possible by creating the need for sustained conversation, problem solving, and joint attention. These social skills groups are labeled in the literature as Lego®-based therapy (LeGoff, 2004; LeGoff & Sherman; Lindsay et al., 2017).

Research is needed in the use of preferred materials that are also likely to be of interest to typically developing peers and family members, to develop skills that may generalize across settings and play partners. This study examined the effectiveness of participation in a school-based social skills group using Lego building activities on the social skills of adolescents with autism spectrum disorder (ASD). At the time of publication, this was the first study to include neurotypical peers as members of the social groups.

What did the researchers do?

In this study, six students with a diagnosis of autism and 12 neurotypical students from an inner-city secondary school in London were selected to participate in a Lego Club. All participants were 12 years old. Autistic participants had a clinical diagnosis of ASD, did not have significant learning difficulties, and were not currently receiving any other social skill interventions.

Six social groups were created with these participants such that each group consisted of one autistic student, two neurotypical students, and one member of the school staff, who was trained in the social skills intervention protocol. The Lego Club groups met twice a week for a total of 45 minutes; 30 minutes of set building following the intervention protocol, and 15 minutes of free build time with buckets of assorted Lego bricks.

The purpose of the study was to investigate two questions: First, the impact of Lego therapy on the social skills of students on the autism spectrum and second, to evaluate whether the participants demonstrate the acquired skills in contexts outside of the Lego Club activities. Club sessions ran on a consistent schedule that began with the assignment of roles for the session, followed by 45 minutes of building time and cleaning up of the bricks. The jobs were randomly assigned and remained constant for the duration of the session. Students did not repeat jobs in the subsequent session. Supervising adults were facilitators, not directors, and their role was to support and encourage participants to work together to solve any problems that arose in the sessions. A fidelity of implementation check list was provided to adults to guide their facilitation of the groups. Students were awarded Lego Club certificates when a building set was completed. Other certificates were awarded for special efforts, such as the Lego Helper certificate which was given when participants were supportive of groupmates.

What did the researchers find?

Baseline data taken prior to intervention revealed near zero levels of frequency of social initiations, responses to initiations by others, and the frequency of positive social behaviors. Results after the intervention showed significant increases in duration of social engagement, frequency of social interactions, frequency of social initiations, and frequency of appropriate responses to initiations. Acquired skills and behavior generalized to the home environment as reported by parents. Teachers also reported decreases in challenging behavior for some participants outside of the social intervention groups.

What are the strengths of the study?

This study expands the research by examining the efficacy of a social skills intervention using Lego bricks in a school setting with typically developing peers, as both role models for autistic participants and as learners themselves. Since social skills intervention can occur at school, this setting increases the social validity of the study by demonstrating that Lego®-based therapy is effective in the school environment with neurotypical peers. The study also demonstrated that training school staff was accomplished with little disruption to the school schedule. Skills acquired by both staff and student participants were maintained in the school environment.

What are the limitations of the study?

Limitations mentioned by the authors include the small size of the group. Additionally, all recruited participants were male and very similar in terms of ages, functioning level, and interests so we can’t extrapolate to other students. Typically developing peers were not included in the assessment of social validity so information about their willingness to engage with classmates on the spectrum in the future was not available. Information about the specific steps in training adults to facilitate and role of adult facilitators was not provided.

Additionally, attributing the changes to working with Lego bricks it is not clear that the use of Lego bricks was instrumental in producing the reported changes. It is equally possible that using any toy preferred by the students would have been helpful in creating the play and social experience reported here. Second, as was stated earlier in the paper, contexts and materials that can be useful for creating pleasurable contexts to establish and strengthen social skills are needed. This suggests the need for continued exploration of settings, materials, and peers to teach social skills and ensure we understand more clearly what produced the favorable outcomes.

What do the results mean?

Results seem to indicate that the Lego therapy as described in the literature can be effective in improving social skills in students on the autism spectrum. It is important to note that the authors of this and other studies (LeGoff & Sherman, 2006; MacCormack, 2015; Narzisi et al., 2021) credit the interaction between the engineer, the supplier, and the builder with that improvement, not the presence of the Lego bricks on their own. Although playing with Lego bricks may be a pleasurable leisure activity for some individuals with autism, it should not be considered as an effective social skills intervention without the inclusion of specific teaching procedures related to socialization. More research is needed to identify other materials that are effective for social skills intervention techniques and strategies.

For more information on the use of Lego-bricks in social skills interventions please read the Lego Therapy Treatment Summary.

References ​

LeGoff, D. B. (2004). Use of LEGO© as a therapeutic medium for improving social competence. Journal of Autism and Development 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. Education & Child Psychology, 37(1), 58-83.

Lindsay, S., Hounsell, K. G., & Cassiani, C. (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.

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.

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).

Peckett, J., MacCullum, 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.

Citation for this article: ​

McKenna, K. (2024). Research synopsis: Lego therapy: Building social skills for adolescents with an autism spectrum disorder. Science in Autism Treatment, 21(02).

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