LEGO therapy and autism: everything is awesome?

'Everything is awesome' (that's awesome not 'awsome') went the very catchy tune accompanying the LEGO movie not so long ago. Given the popularity of those colourful interlocking plastic bricks down the years, it was perhaps unsurprising that the film did so well and with the promise of more to come.

Aside from helping to influence generations of would-be engineers and dreamers (a double-decker couch?), LEGO has also found something of a following in relation to labels like autism (see here). Perhaps also why games such as Minecraft have 'taken off' with autism in mind, is the very 'systemising-based' principles behind LEGO and how, minus sweeping generalisations, autism and systemising have some research history (see here).

A recent paper by Helen Peckett and colleagues [1] adds to the small but emerging peer-reviewed research base looking at LEGO and autism, and specifically the idea that: "findings are supportive of previous Lego Therapy studies and have implications for strengths-based service provision." Peckett et al actually explored "mothers' experience of implementing Lego Therapy at home within the family" within the context of paediatric autism. Rather than assessing the intervention in a clinical trial manner (i.e. randomised, placebo-controlled, etc. study) the onus was on what mums of children with autism actually thought about the use of LEGO therapy. I know to some people this might seem like 'fluffy science' but in the context of a heterogeneous label like autism, I do think there is place for such research. More so when such intervention is designed to be carried out in the home environment with parents and siblings as intervention deliverers.

Suffice to say that much of the maternal discussions about LEGO therapy were quite positive in line with previous findings [2] and not just in the short-term [3]. As per the title of the paper, family relationships were a winner following the intervention, probably as a consequence of the greater involvement between mother and child (and siblings) in line with other reported findings (see here). There were however some fairly down-to-earth comments made about the intervention during the "interpretative phenomenological analysis" not least about "the impact of the intervention in the wider context." In other words, whilst LEGO therapy (or just playing with LEGO in a more structured way) may indeed have some value in terms of social skills such as sharing and turn-taking for example, how does this translate outside of the LEGO therapy context?

Similar questions could probably be asked about the use of Minecraft and related platforms too, bearing in mind how such 'gaming' probably does little to address important issues such as the promotion of physical activity for example [4] and the benefits that sports can potentially bring to some of the autism spectrum. That screen time might also have a negative side in terms of self-reported inattention in other groups [5] is something else to consider, as are other reports in the peer-reviewed literature [6].

By saying all that I'm not trying to poo-poo LEGO or Minecraft; I'm just saying that outside of being recreational activities, one has to be a little guarded about turning every play and leisure activity into 'therapy'. I might also mention how addictive LEGO and/or Minecraft can be; something which I assume can be as much of an issue for parents of children on the autism spectrum as it is for everyone else when it comes to getting children on to other tasks. Oh, and LEGO certainly isn't cheap either...

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[1] Peckett H. et al. Maternal experience of Lego Therapy in families with children with autism spectrum conditions: What is the impact on family relationships? Autism. 2016 Feb 5. pii: 1362361315621054. 

[2] Owens G. et al. 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. J Autism Dev Disord. 2008 Nov;38(10):1944-57.

[3] Legoff DB. & Sherman M. Long-term outcome of social skills intervention based on interactive LEGO play. Autism. 2006 Jul;10(4):317-29. 

[4] Bremer E. et al. A systematic review of the behavioural outcomes following exercise interventions for children and youth with autism spectrum disorder. Autism. 2016 Jan 28. pii: 1362361315616002.

[5] Montagni I. et al. Association of screen time with self-perceived attention problems and hyperactivity levels in French students: a cross-sectional study. BMJ Open. 2016; 6:e009089.

[6] MacMullin JA. et al. Plugged in: Electronics use in youth and young adults with autism spectrum disorder. Autism. 2016 Jan;20(1):45-54.

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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 : the international journal of research and practice PMID: 26851230