No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
A scoping review of the role of LEGO® therapy for improving inclusion and social skills among children and youth with autism
Abstract
LEGO® therapy uses children's natural interest in play to help motivate behavioural change and may be an effective teaching tool to increase social competency and communication skills. Although the literature is growing it has not been synthesized. The objective was to review the literature on the role of LEGO therapy on social skills and inclusion among children and youth with autism spectrum disorder.A scoping review was conducted, involving comprehensive searches of international databases. Eligible articles included:
(a) youth aged 19 or younger, with ASD; (b) empirical research on LEGO® therapy interventions; (c) published
from 1996 to 2016 in a peer-reviewed journal, conference proceedings, or dissertation.
Results: Of the 6964 studies identified, 15 articles—involving 293 participants, aged 5–16 (mean age 8.7 years), across five countries—met the inclusion criteria. Although the outcomes of the LEGO® therapy varied across the studies, 14 studies reported at least one improvement in social and communication skills (e.g., building friendships, improved social interactions and social competence), ASD-specific behaviors, belonging, family relationships, coping, and reductions in playing alone.
Conclusions: Although LEGO® therapy shows promise as an intervention for children and youth with ASD, more rigorously designed studies are needed to fully understand its impact.
... When used with children, a group of three usually work with an adult facilitator, and participants adopt one role per session, harnessing their natural interest and motivation to collaboratively build a leGO® set with a social division of labour [10,11]. leGO® therapy has been found to be effective in increasing social skills [12,13] and reducing maladaptive behaviours [12] in children up to 16 years. in their systematic review, Narzisi et al. (2021) [13] examined 19 studies that investigated leGO® therapy as an intervention to increase social skills in 226 autistic children aged 3-16 years. ...
... When used with children, a group of three usually work with an adult facilitator, and participants adopt one role per session, harnessing their natural interest and motivation to collaboratively build a leGO® set with a social division of labour [10,11]. leGO® therapy has been found to be effective in increasing social skills [12,13] and reducing maladaptive behaviours [12] in children up to 16 years. in their systematic review, Narzisi et al. (2021) [13] examined 19 studies that investigated leGO® therapy as an intervention to increase social skills in 226 autistic children aged 3-16 years. ...
... the authors concluded that despite the overall low quality of studies, there was a positive theme of skill development in social competence and communication. it was found that leGO® therapy could be successfully used flexibly across different settings (school, clinic, home) and between both group and dyadic programs. similarly, an earlier scoping review on the use of leGO® therapy found 15 studies (1996-2016) that explored the effectiveness of leGO® therapy on the social skills of 293 autistic children and adolescents [12]. the findings from fourteen studies indicated improvements in at least one social and/or communication skill, an increased sense of belonging and coping skills, a reduction in difficult behaviours, and an increase in playing with others. ...
There is emerging evidence that LEGO® therapy is an effective way of supporting younger autistic children develop their communication and social skills. LEGO® robotics therapy - which uses the principles of LEGO® therapy applied to LEGO® robotics - may be an age-appropriate intervention to reduce anxiety and increase social skills in autistic adolescents. The aims of this study, involving 24 autistic students aged 13-16 years, were to examine (a) the effect of an 8-week LEGO® robotics therapy on students' anxiety, social skills, academic motivation, and engagement, and (b) the views and perceptions of all stakeholders (students, parents, school staff and facilitators) regarding the program. An adapted explanatory sequential basic mixed-methods design was used. Groups of three students supported by two facilitators participated in the LEGO® robotics therapy for eight sessions at school. Quantitative data was collected before and after therapy using the Anxiety Scale for children-Autism Spectrum Disorder, Social Skills Improvement System and the Motivation and Engagement scale. Qualitative data was collected using open-ended online questionnaires, interviews, and focus groups from all stakeholders. No statistically significant within group differences were found in relation to students' anxiety, social skills, motivation and engagement before and after the program. Qualitative findings indicated predominantly positive student experiences and outcomes such as better school attendance, increased confidence, and social skills. The findings suggest that LEGO® robotics therapy may be associated with a range of nuanced positive experiences and outcomes for individuals and groups of students, suggesting potential value in further efforts to refine the program.
... One playful intervention that addresses social abilities, and both externalizing and internalizing behaviors with efficacy is LEGO ® -based stimulation [14][15][16]. This approach has gained attention as a structured social development tool, particularly for children with ASD. ...
... This approach has gained attention as a structured social development tool, particularly for children with ASD. The efficacy of this approach has been corroborated by a substantial body of research as an effective method for enhancing collaboration, communication, and social interaction between children [15,16]. It equips children with essential skills for interacting with others, including conversation and problem-solving abilities [14][15][16]. ...
... The efficacy of this approach has been corroborated by a substantial body of research as an effective method for enhancing collaboration, communication, and social interaction between children [15,16]. It equips children with essential skills for interacting with others, including conversation and problem-solving abilities [14][15][16]. ...
Background: LEGO®-based therapy is a social development protocol that uses LEGO® activities to support the development of a wide range of interaction skills, enhancing prosocial behaviors and mitigating the challenges associated with mental health difficulties and behavioral issues commonly observed in children with autism spectrum disorder (ASD). Objectives: This study aimed to explore the effects of LEGO®-based therapy on the social behavior and mental health of children with ASD, comparing stimulation mediated by expert and stimulation mediated by non-autistic peers. This study was approved by the Ethical Committee at Mackenzie Presbyterian University, ensuring adherence to ethical standards throughout the research process. Methods: This study involved 18 children with ASD, levels 1 or 2, with an intelligence quotient (IQ) above 70, and three typically developing peers, intelligence quotient (IQ) above 80, aged between 5 and 8 years old, of both sexes. Participants were randomized into three groups for stimulation (stimulation mediated by expert, by a non-autistic peer and control group). The measures were the Wechsler Abbreviated Scale of Intelligence, the Strengths and Difficulties Questionnaire (parent and teacher versions), the Inventory of Difficulties in Executive Functions, Regulation, and Aversion to Delay—Child Version, the Developmental Coordination Disorder Questionnaire, the Autism Behavior Checklist, and the Autistic Behavior Inventory. Results: After 14 sessions of 45 min in school settings, the participants of both groups (mediated by experts and non-autistic children) showed significant gains on social behavior. A statistically significant difference was observed between baseline sessions and probes (χ2 (5) = 25.905, p < 0.001). These gains were maintained in both follow-up points, 30 and 90 days after the completion of the stimulation sessions. Additionally, maladaptive behavior showed a significant decline when compared pre- and post-intervention. These improvements were sustained during follow-up assessments at 30 and 90 days. Conclusions: The results suggest that a structured intervention combined with peer-mediated stimulation may be an effective method for promoting adaptive and prosocial behaviors in children with ASD.
... The use of Legos in therapy for clients with ASD is a very innovative idea because it uses a client's natural interests as a catalyst for therapy (LeGoff, 2004;Lindsay et al., 2017). LeGoff (2004) even made Lego therapy its own niche for promoting prosocial skills and interactions in clients with ASD (Ezzamel, 2017;Lindsay et al., 2017). ...
... The use of Legos in therapy for clients with ASD is a very innovative idea because it uses a client's natural interests as a catalyst for therapy (LeGoff, 2004;Lindsay et al., 2017). LeGoff (2004) even made Lego therapy its own niche for promoting prosocial skills and interactions in clients with ASD (Ezzamel, 2017;Lindsay et al., 2017). There have been multiple articles promoting Lego therapy and the majority of research and articles find it to be an effective intervention (Lindsay et al., 2017). ...
... LeGoff (2004) even made Lego therapy its own niche for promoting prosocial skills and interactions in clients with ASD (Ezzamel, 2017;Lindsay et al., 2017). There have been multiple articles promoting Lego therapy and the majority of research and articles find it to be an effective intervention (Lindsay et al., 2017). With all of this being said, there is very little empirical evidence that Lego therapy or the use of Legos in therapy is an effective intervention. ...
Wrote this as part of my doctoral work.
... Thus, it exploits CCT deficits and good systemizing skills to enhance EF and to mitigate ToM deficits. Lego® therapy uses the ability of ASD children as a motivating variable for learning and behavioral change [22]. The choice of Lego® as a tool for social development therapy is in part related to Attwood's concept of "constructive application" and the proven usefulness of using the child's interests to motivate both learning and change [23]. ...
... Participants need to focus on the task at hand, remember instructions and adapt their actions accordingly. These cognitive processes are essential for the successful completion of the building tasks and can have positive carry-over effects in other areas of life [21,22]. Collaboration and Social Interaction: Lego therapy is typically conducted in small groups, requiring participants to work collaboratively towards a common goal. ...
... This cooperative play fosters social interaction, turn-taking, communication, and negotiation skills. Engaging in shared problem-solving tasks also promotes perspective-taking and understanding others' points of view, which are crucial components of social cognition [21,22]. ...
Over the years, several interventions have been implemented, including Lego® Therapy, with the aim of supporting and implementing social and communication skills impairments in Autism Spectrum Disorders (ASD). Although recent studies have shown that the ability to learn implicitly is preserved in ASDs, no study related to Lego® Therapy has analyzed whether and how this training can also affect aspects not directly treated. In this study, we report a first attempt of assessment of Lego® Therapy's effect on the specific area of cognitive skills in an ASD child. Over a period of 12 months, a child with ASD had weekly meetings with an expert operator of Lego® aiming to improve the child's ability to communicate, reduce impulsiveness and hyper verbalism, and encourage pro-social behavior. The intervention resulted in positive outcomes that were assessed after 12 months.
... Single-case studies were excluded in order to reduce the risk of bias (Schünemann et al., 2013). Studies based on therapeutic interventions such as play therapy, Lego therapy and drama therapy were excluded given that these approaches are based on the therapeutic properties of play (Association for Play Therapy, 2020; Drews & Schaeffer, 2016) and extend beyond the definition of play in this review and have been systematically examined within other literature (Hillman, 2018;Lindsay et al., 2017). ...
... Complementary backward chaining was also conducted given that database searching is not exhaustive (Evans & Benefield, 2001). The reference lists of the seminal articles identified (and listed) above were searched for eligible studies alongside the examination of the bibliographies of previous systematic reviews in the area (Alagendran et al., 2019;Cornell et al., 2018;Gibson et al., 2020;Godin et al., 2019;Jung & Sainato, 2013;Kent et al., 2020a;Kossyvaki & Papoudi, 2016;Kuhaneck et al., 2020;Lai et al., 2018;Lang et al., 2011;Lindsay et al., 2017;Lory et al., 2018;Mpella & Evaggelinou, 2018;Pyle et al., 2017). Overall, this process yielded an additional 130 citations resulting in a total of 1041 articles for potential inclusion. ...
... This finding supports recommendations by Gibson et al. (2020) in their recent scoping review of play-based interventions to support social communication development of children, aged 2-7, with ASD in which they highlighted the need for increased rigor in research on play-based interventions for the social communicative development of children with ASD. Finally, given the multi-faceted nature of both play and social communication, future research should provide an account of the theoretical approaches underpinning the play interventions, as recommended within similar reviews (Gibson et al., 2020;Ke et al., 2018;Lindsay et al., 2017). ...
Children with autism spectrum disorder (ASD) experience social communication difficulties which can be compounded by increased social demands and expectations of the school environment. Play offers a unique context for social communication development in educational settings. This systematic review aimed to synthesize play-based interventions for the social communication skills of children with ASD in educational contexts and identified nine studies. Overall, studies in this review provided a promising evidence base for supporting social communication skills through play in education for children with ASD. The review also highlighted gaps in research on play-based interventions for the social communication skills of children with ASD within naturalistic educational settings.
... Indeed, children with ASD exhibit difficulties in establishing friendships and playing cooperative games [10], and they are consequently poorly included in social life [11] and are more vulnerable to demoralization, depression [12], anxiety [13] and low self-esteem [14]. Given that social participation is a key predictor of quality of life and overall functioning, it is crucial to enhance the social functioning of these children [15]. Many interventions aiming to improve social abilities have been studied, but few of them are evidence-based [16] and/or have reliable and valid methods for measuring social skills [17]. ...
... Third, the sample size of the studies was small. Fourth, there was an extreme variability in terms of clinical and socio-demographic characteristics [15,63]. Fifth, we decided to use a relatively narrow search strategy to identify only studies assessing the effects of LEGO ® -based therapy on ASD; following this, some studies may have been missed if they used terms such as neurodevelopmental disorders or social communication problems; however, on the other hand, our decision allowed us to increase the specificity of the intervention target. ...
... For these reasons, caution should be used in generalizing the findings. In agreement with Lindsay [15], future research trials should include greater sample sizes and more rigorous RCT designs, along with standardized measures. Interestingly, in 2019, Varley [64] and colleagues published a promising study protocol describing their forthcoming multicenter, pragmatic and RCT study, which will contribute to the achievement of more significant results to be generalized. ...
LEGO®-based therapy is a social skills development program aimed at children with autism spectrum disorder (ASD). A systematic review of the literature was conducted using PRISMA guidelines. PubMed, Scopus and Web of Science bibliographic databases were searched from their date of inception to August 2020. The review included 19 studies. Studies were classified according to experimental designs (e.g., Randomized Control Trial, Non-Randomized Studies of Interventions and case report and series) and a narrative synthesis of each was provided, along with a critical discussion of the strengths and weaknesses of the available literature on the topic. Although LEGO®-based therapy appears a promising treatment for social interaction in ASD, the findings of LEGO®-based therapy studies should be interpreted and generalized with caution, due to the low quality of the studies and the small sample sizes.
... Blocks, of course, naturally provide an opportunity to express one's tastes and, as part of a collection, are the object of research into the externalization of a personalized interior (Botorić 2023). Other examples of literature reviewing the use of LEGO bricks include robotics/behavioral patterns (Fitriyaningsih et al. 2019;Xia and Zhong 2018), autism treatment (Lindsay et al. 2017;Narzisi et al. 2021) or education/teaching more broadly (Horikoshi 2021;Warburton et al. 2022). The construction phenomenon of LEGO bricks also finds application in architecture (Fisher 2017;Zhou et al. 2019) or the energy industry (Yun et al. 2022). ...
... There is an increasing emphasis on the role of schools in striving to shape and improve social outcomes in autistic children, and with the use of LBT, improvements in communication and social skills are observed during the sessions . These therapies also have a positive effect, according to the literature review, on improving ASD-specific behaviors, belonging, family relationships, coping, and reductions in playing alone (Lindsay et al. 2017). This area of research is still being developed and the literature continues to provide us with new evidence for the effectiveness of LBT in children and adolescents. ...
This article presents a bibliometric study of articles and reviews articles released between 1972 and 2022, about using the LEGO topic and its interpretation in the scientific literature. This study aims to scientifically explore the evolution of global research on the use of the LEGO theme in scientific literature uncovering its most relevant use in scientific research. The analysis includes figures on the occurrence of keywords, main journals, most cited papers and authors, and their country of origin. In the literature review, 1398 publications found in 77 countries were published in 951 journals. The papers, primarily, came from the USA. The top journal include the International Journal of Engineering Education with 16 articles. However, the leading publisher was Elsevier with 234 papers. The results of the bibliometric analysis showed that from the total 7393 keywords, we formed 6 thematic clusters. The analysis shows the multidimensionality of the use of LEGO blocks/bricks and the LEGO topic in the scientific literature: whether in the social or the natural sciences, and the last years of the study show a continuous growth of works with an exponential trend line with a value of R² = 0.936. In the future, the scope of the analysis should be extended to gather a complete picture of the data on the use of the LEGO topic in the scientific literature.
... Contrary to the predictions of local-to-global precedence and bottom-up theories of autistic perception, autistic individuals have been found to show either superior or comparable performance to neurotypical controls in visuospatial reasoning, often in tasks that require switching between local and global processing, high-level mental imagery, and topdown processing [10,19]. A real-world example of this is seen in building blocks or Lego, a game which is gaining increasing significance for its therapeutic benefits in supporting autistic children in their social communication development [20]. Conducting fundamental research on how autistic people perceive and process the raw (digital) materials used in playbased interventions such as Lego and its modern counterpart, Minecraft, may help to understand the mechanisms by which these therapies can help autistic people, whether through sensory perception or other cognitive domains like executive functioning. ...
... This strengths-based approach is increasingly employed in therapies, with the use of strengths strongly predicting better quality of life, subjective well-being, and lower levels of anxiety, depression, and stress in autistic people [44]. If autistic people have a similar drive to non-autistic people for perceptual cohesion of these block shapes, as our findings suggest, this could help explain why playtherapies and communities based on the use of e.g., Lego and Minecraft are being shown to help with social communication, engagement, and mental well-being in the autistic community [20,[45][46][47]. ...
Background
When working on jigsaw puzzles, we mentally “combine” two pieces to form a composite image even before physically fitting them together. This happens when the separate pieces could logically create a cohesive picture and not when they are mismatched or incoherent. The capacity of the brain to combine individual elements to form possible wholes serves as the basis of perceptual organisation. This drive for perceptual cohesion—the “Tetris effect”—can be seen in the famous game, where people automatically perceive logical combinations from separate pieces. However, it is unclear how this presents in populations known to have perceptual differences, such as autistic people. Theories on the inclination to process local over global details in autism and autistic strengths in pattern recognition lead to conflicting predictions regarding the drive for perceptual cohesion in autistic compared to non-autistic people.
Methods
In this large-scale (n = 470) pre-registered online behavioural study, we aimed to replicate previous research conducted on neurotypical participants and to extend this work to autistic participants. We used two tasks with Tetris-style stimuli to examine how autistic (n = 196) and non-autistic (n = 274) adults implicitly perceive possible wholes from individual parts. Data were analysed using logistic mixed-effects regression models and hierarchical Signal Detection Theory modelling.
Results
Overall, we replicated the results from the original study in finding participants are more likely to perceive parts as wholes when there is the potential to form a whole, compared to when there is not. However, we found no differences between autistic and non-autistic participants across both tasks.
Limitations
Although power calculations were carried out to assess sample sizes needed to detect a group difference, given the small effect size (Cohen’s d = 0.37) in the original study, it may be that any existing group differences are still undetectable with the current sample size.
Conclusions
We conclude that the “Tetris effect” is ubiquitous and seen in both neurotypical and neurodiverse populations. Our findings challenge the deficit-focussed narrative often seen in the autism literature and highlight the similarities in task performance between autistic and non-autistic participants.
... In a second study by Hughes et al. [35] with neurodiverse adolescents involving Circuit design, T-shirt design, coding, and 3D Printing, quantitative analysis of surveys revealed motivation and self-efficacy improved with time. Heightened motivation in tasks that blend formal and informal learning, like LEGO robotics building, can help neurodiverse students engage in computational thinking, valued in STEM and STEAM careers [36]. Ngyuen's [37] study, concerned with the mental health of students with autism, found adaptive improvements in feelings of separation anxiety, and in tackling unfamiliar situations during learning post LEGO-related making and tinkering activities. ...
... In sum, our results showcase how teacher and peer driven contingent support created a classroom culture that thrived on adaptive sociocognitive processes involved in design thinking. Extant literature in special education has shown that makerspace curricula can heighten students' self-reported perceptions related to design thinking [35,36], enhance well-being [37], and improve executive functioning [33]. Studies have also shown positive effects on students' social skill development [29,30], group-level problem-solving [6,32], and relationships with family [31]. ...
This mixed methods case study employed Vygotsky’s theory to show how peer and teacher contingent support created individualized zones of proximal development for three students with learning differences in a high school makerspace class at a special education institution. Our results expand extant literature by highlighting the intra- and interpsychological potential of makerspace curricula, specifically for students with learning differences. We employ mixed methods analyses of self-reported responses related to emergent problem navigation, a narrative of class fieldnotes, and visuals of whole class projects to describe full class and individual project-based learning activities. Aggregated results from three students showcase stability in design thinking perceptions through the course of weekly whole class design challenges involving TinkerCAD, Homestyler, and material fabrication techniques. A single student example articulates how similar self-reported perceptions were observed in the non-linear development of an individual project for an end-semester Arts Festival.
... In the context of cognitive habilitation, there are several interventions for cognitive impairment neurohabilitation, such as cognitive training, cognitive stimulation, and cognitive rehabilitation; some are computer-based, while others are noncomputer-based or mixed [43]. One of these neurohabilitation methods is LEGO ® -based therapy (LEGO ® B-T), which promotes neuronal connectivity and cortical plasticity through the use of assembly sets and robotic programming, with the goal of improving neurocognitive processes [44]. This method involves multiple assembly and gearing steps aimed at promoting the cognitive work of various processes, such as attention, memory and executive function [45]. ...
... Finally, as reported in other studies, LEGO ® B-T has proven to be a good tool for cognitive and social neurohabilitation in patients with congenital heart disease, patients with autism, and elderly people [44,45,47,65]. In clinical practice, the perspectives are to promote the development of communication (linguistic, operational, social, strategic) and emotional well-being, to develop social skills such as turn taking, joint attention, sharing, joint problem solving, and listening in the epileptic children, and to reduce the costs by reducing the time required for resources personalization. ...
In the pediatric population, epilepsy is one of the most common neurological disorders that often results in cognitive dysfunction. It affects patients’ life quality by limiting academic performance and self-esteem and increasing social rejection. There are several interventions for the neurohabilitation of cognitive impairment, including LEGO®-based therapy (LEGO® B-T), which promotes neuronal connectivity and cortical plasticity through the use of assembly sets and robotic programming. Therefore, the aim of this study was to analyze the effect of LEGO® B-T on cognitive processes in pediatric patients with epilepsy. Eligible patients were identified; in the treatment group, an initial evaluation was performed with the NEUROPSI and BANFE-2 neuropsychological tests. Then, the interventions were performed once a week, and a final test was performed. In the control group, after the initial evaluation, the final evaluation was performed. An overall improvement was observed in the LEGO® B-T patients, with a significant increase in BANFE-2 scores in the orbitomedial, anterior prefrontal, and dorsolateral areas. In addition, in the gain score analysis, the orbitomedial and memory scores were significantly different from the control group. LEGO® B-T neurohabilitation is a remarkable option for epilepsy patients, who are motivated when they observe improvements.
... Empirical evidence for LEGO-based intervention has emerged in recent years. Promising results include improved social communication skills for children and youth on the autism spectrum (Levy & Dunsmuir, 2020;Lindsay et al., 2017;Narzisi et al., 2021). Although developed originally in clinical settings as a therapy for children on the autism spectrum, LEGO-based intervention can be modified to accommodate the needs of individual children and implementation settings (LeGoff et al., 2014). ...
... These data provided preliminary support for parent-mediated LEGO intervention. More research is needed to test the efficacy of LEGO intervention with parents as implementers in the home setting (Levy & Dunsmuir, 2020;Lindsay et al., 2017;Narzisi et al., 2021). Specifically, verifying outcome variables with reliable measures and measuring fidelity of implementation is an important part of evaluating the effects of interventions conducted by parents at home. ...
Given the impact of the global pandemic on children’s schooling and learning, evidence for interventions implemented by parents is urgently needed. This study aimed to evaluate the effects of a parent-mediated LEGO intervention on the social interactions of four children on the autism spectrum. The intervention involved four sets of two parents engaging with their child in collaborative LEGO construction, with each person assigned a role as Engineer, Supplier, or Builder. Using a multiple probe design across the four family triads, the intervention effectively increased spontaneous social initiations and responses in all four children, and these behaviors were maintained for 6 weeks following the intervention. The effect on inappropriate interactions was not detected; parental prompts increased in initial intervention sessions but decreased over time. Parents implemented the intervention at home with high fidelity. Efficacy of the intervention and potential benefits of virtual parent training are discussed.
... Unfortunately, evaluations of the effectiveness of the approach have been difficult to develop because many of the studies utilized a variety of approaches (group-based, one-on-one, combination of both) with small, non-random samples. Despite those methodological difficulties, a scoping review of the studies of LEGO therapy published between 1996 and 2016 (Lindsay et al., 2017) rated LEGO therapy as 'possibly effective' (p. 180) and suggested a level C rating according to the American Academy of Neurology (Getchius et al., 2010). ...
... Calls for rigorous, randomized control trials and larger samples have been ubiquitous in the research on play-based social interventions (Arenas et al., 2022;Lindsay et al., 2017;Silva et al., 2021) so those goals bear repeating here. As noted, the evidence for the value of play-based social interventions has been limited because of the wide variety of dependent variables (e.g. ...
For youth on the autism spectrum, play offers rich opportunities for the development of social competence. Play-based activities are well suited for social skills interventions because the structure of the game play can easily incorporate the youths’ interests and can be designed to mimic social rules. Despite the wealth of literature on the topic of play-based learning, it is not clear how play factors such as play materials (toys, objects, imaginative spaces), permissiveness (player autonomy), and structure (role-based play, interaction rules) contribute to skill development. This paper reviews the literature on play-based social interventions and will compare three play-based approaches based on materials, permissiveness, and structure: (a) LEGO-therapy, (b) virtual environment social program, and (c) therapeutically applied role-playing games. Implications of the results for practitioners and researchers are discussed.
... The objective of this study was to examine the efficacy of an 8-week physical exercise intervention specifically designed for younger children with ASD from underserved populations to reduce anxiety, and to compare to a sedentary activity intervention using commercial block and computer games such as LEGO R and Minecraft. Play based interventions using LEGO and Minecraft are very popular in children with ASD and emerging evidence suggests potential positive effects on social communication and interactions (Cadieux & Keenan, 2020;Lindsay et al., 2017;Narzisi et al., 2021) and even hippocampal memory formation (Clemenson et al., 2019). Less is known about the effects of LEGO and Minecraft interventions in children with ASD, which are sedentary activities. ...
... We hypothesized that physical exercise reduces anxiety but the decreases in the sedentary LEGO/Minecraft group have not been previously reported. This novel finding suggests that LEGO and Minecraft interventions may not only improve cognitive and social behaviors as described in previous studies (Cadieux & Keenan, 2020;Clemenson et al., 2019;Lindsay et al., 2017;Narzisi et al., 2021) but also reduce anxiety in children with ASD. However, without a non-activity control group it remains difficult to determine if this is a true effect of intervention. ...
Background
Anxiety is a frequent comorbidity in children with autism spectrum disorder (ASD). Physical exercise is a low cost and easy-to-access intervention with therapeutic benefits for reducing anxiety in adults and adolescents. There are currently no randomized controlled trials on the feasibility and efficacy of a physical exercise intervention to reduce anxiety in younger children with ASD.
Method
148 children (6–12 years old) with ASD were randomized into a clinical trial to evaluate the efficacy of an 8-week exercise protocol designed to reduce anxiety specifically in younger children with ASD. Participants were randomized to an exercise intervention group (N = 76) or sedentary activity LEGO/Minecraft group (N = 72). Both programs were administered 1–3 times weekly for 8 weeks. Anxiety was assessed via parent ratings with the Child Behavior Checklist DSM-5 anxiety subscale (CBCL DSM-5) at weeks 1, 3, 6, and 8 as well as follow up at weeks 12 and 16. Secondary outcome measures included child self-reported anxiety (Screen for Child Anxiety Related Disorders; SCARED), sleep (Child’s Sleep Habits Questionnaire, CSHQ-ATN), physical activity level (Physical Activity Questionnaire, PAQ-C), and salivary cortisol measured at weeks 1, 3, 6, and 8.
Results
Parent-rated (CBCL DSM-5) and self-reported (SCARED) anxiety scores showed improvements at weeks 3, 6 and 8 in both groups with no significant differences between the physical exercise and sedentary activity (LEGO/Minecraft) groups. In addition, the CBCL DSM-5 anxiety scores decreased only in the physical exercise group at weeks 12 and 16 compared to baseline with no significant difference from LEGO/Minecraft group. Sleep also showed improvements during weeks 6 and 8 in the physical exercise group but not in the LEGO/Minecraft group with no significant differences between the groups. Physical activity level was significantly increased in the physical exercise group compared to the LEGO/Minecraft group at week 8. Salivary cortisol did not show any significant changes from weeks 1–8 or differences between groups.
Conclusion
Eight-week physical exercise and sedentary LEGO/Minecraft interventions reduced parent-rated and self-reported anxiety in 6–12-year-old underserved children with ASD with no significant difference between the intervention groups.
... Results were promising, however the sample size was small (n = 47) and full randomization was not used. A scoping review of LBT carried out in 2017 (Lindsay et al., 2017) concluded from the 15 studies included that more rigorously designed evaluation of the programme with larger samples, randomization processes, and standardized measures was necessary. One recent small-scale study was undertaken in a school context in 2020, although this was not an RCT and included only six participants (Levy & Dunsmuir, 2020). ...
... As noted in the 2017 scoping review (Lindsay et al., 2017), studies of LBT to date have lacked methodological consistency, power, standardized measures, and full randomization, nor have they assessed costeffectiveness or acceptability of the intervention. Acceptability can be defined as 'a multi-faceted construct that reflects the extent to which people delivering or receiving a healthcare intervention consider it to be appropriate, based on anticipated or experienced cognitive and emotional responses to the intervention' (Sekhon et al., 2017: 4). ...
Many autistic children and young people need extra support with social skills. Social skills programmes, such as LEGO® based therapy (LBT), are commonly used to help with these difficulties. The aim of this study was to examine the acceptability of LBT using qualitative interviews and questionnaires with facilitators and parents/guardians on behalf of autistic children and young people. Acceptability was measured in line with constructs of the Theoretical Framework of Acceptability. Questionnaires were analyzed descriptively and between group comparisons were undertaken using the Mann–Whitney U Test. Telephone interviews were undertaken with a sub‐sample of facilitators. All interviews were recorded, transcribed verbatim, and framework analysis was performed by two researchers supported by NVivo. The questionnaire response rate was 80% for facilitators and 77% for parents/guardians. Overall acceptability, measured on a 1–5 (minimum–maximum) scale, was high for both facilitators and parents/guardians with a median (range) of 5 (4–5) and 4 (3–5), respectively. Facilitators rated the acceptability of the programme significantly higher overall than parents ( p < 0.001). Facilitators reported that participants and wider school staff viewed the programme positively. They observed improvements in communication and social skills during the sessions. Potential barriers to programme delivery, such as resources and staff schedules, were identified but facilitators reported that these challenges did not outweigh the benefits. There is increasing emphasis on the role of schools in seeking to improve social outcomes for autistic children therefore this high degree of acceptability makes this an attractive school‐based programme for schools, autistic children and their families.
Lay Summary
Social skills programmes, such as LEGO® based therapy (LBT), are often used to help autistic children and young people with their social skills. The acceptability of LBT with school staff and parents/guardians on behalf of children and young people was explored using interviews and questionnaires. Our results show that LBT is viewed as a highly acceptable programme that can help autistic children and young people improve their communication and social skills.
... Contemporary research has found that physical manipulative play, such as with LEGO bricks, gives children opportunities to simultaneously develop language and socioemotional skills, and further foster creativity and imagination (Honey et al., 2007;. Through the medium of structured play, LBT aims to facilitate crucial social skills such as turn-taking, active listening, problem-solving and teamwork (Lindsay et al., 2017). Children are assigned to one of three roles: parts supplier, builder or engineer. ...
LEGO-Based Therapy (LBT) is a play-based social skills intervention which is being employed widely in schools across the UK to support autistic students’ social and emotional wellbeing. However, the existing literature lacks insight into how the children themselves experience and benefit from this intervention. Furthermore, there is a need for research that engages with under-represented autistic individuals (e.g., those with accompanying cognitive, behavioural and language difficulties). The
following study explored autistic students’ experiences with LBT and aimed to answer whether and how this intervention supports their social and emotional wellbeing in school. The experiences of 14 autistic students with accompanying cognitive, behavioural or language needs (Nfemale = 2, Mage =10.14 , NCaucasian = 5) from an independent special school in London were captured using video recorded semi-structured interviews. Multimodal qualitative analysis yielded three key themes: i. Students have positive experiences with LEGO, ii. Majority of students have positive experiences with LBT, and, iii. LBT helps the majority of students and they have suggestions on how it can be better adapted to support them. These findings and the methodology are discussed and emphasise that in order to better represent the entire spectrum of needs in the autistic community in school-based research, future research can use mixed-method approaches which promote positive rapport so neurodivergent children and young people feel empowered to share their experiences through a medium which supports their needs.
... ATs leverage artistic expression to improve the physical and mental well-being of individuals, facilitating their rehabilitation [11]. Employing a range of artistic media such as painting [12], music [13], gaming [14], dance, and movement [15], ATs provide a nonverbal communication channel aimed at enhancing patients' quality of life [16,17]. Schweizer [18] reported in a meta-analysis comprising 18 descriptive cases that ATs enhanced social behavior, flexibility, and attention skills among children with ASD. ...
Purpose
Arts therapies (ATs) for the treatment of autism spectrum disorders (ASD) has attracted widespread attention from scholars. However, resources, technical, and ethical issues still pose significant obstacles to current research. A collaborative design approach is needed to guide the intervention treatment process involving multiple stakeholders. Therefore, this study focuses on exploring the current status, development and potential value of the collaborative arts therapies (CATs), providing a comprehensive perspective for subsequent research.
Methods
The Web of Science, PubMed, ScienceDirect, and Cochrane Library were searched for publications up to August 30, 2023, related to the use of CATs for the treatment of ASD. CiteSpace was used to build a knowledge graph to achieve visual analysis of current research countries, institutions, journals, authors, and hot topics.
Results
A total of 845 articles met the inclusion criteria. In terms of quantity, the USA is the leading country which has the greatest influence in advancing the field. The University of Haifa is the most productive institution. Arteterapia Papeles De Arteterapia Y Educacion Artistica and Frontiers in Psychology occupy key publishing positions. The most central keywords were related to the quality of life of people with ASD. “family”, “social robot” and “participation” are emerging topics in the research field. The positive impact of the combination of caregivers, technology and artistic media on enhancing connections between people with ASD and their everyday environment is the focus of current research.
Conclusions
Research on CATs as an adjunctive therapy for the treatment of ASD is evolving. Providing comprehensive rehabilitation and support intervention for patients with ASD is a key research direction. The research process requires more interdisciplinary resources and technical assistance. Collaboration will be the best way to improve the effectiveness of ATs.
... Also, for several years now, work has been done on new therapies for improving inclusion and social skills among children and youth with autism. Two commonly used elements to attain these objectives are Lego therapy [19] and music [36]. A system based on Lego, which allows creating music in an interactive and collaborative way, as the one presented in this paper, can be very useful for the treatment of children and youngsters with autism. ...
In this paper, a system to build music in an intuitive and accessible way, with Lego bricks, is presented. The system makes use of the new powerful and cheap possibilities that technology offers for making old things in a new way. The Raspberry Pi is used to control the system and run the necessary algorithms, customized Lego bricks are used for building melodies, custom electronic designs, software pieces and 3D printed parts complete the items employed. The system designed is modular, it allows creating melodies with chords and percussion or just melodies or perform as a beatbox or a melody box. The main interaction with the system is made using Lego-type building blocks. Tests have demonstrated its versatility and ease of use, as well as its usefulness in music learning for both children and adults.
... Interventions that support social skills have been developed and widely used to support social connection for autistic individuals (D'Amico et al., 2015;Ghasemtabar et al., 2015;Koning et al., 2013;LaGasse, 2014;Lindsay et al., 2017). Although there is evidence that social skills training can reduce feelings of loneliness and can foster belonging (Gantman et al., 2012), other findings suggest that offering social skills training, or interventions to increase opportunities for social contact, can be inappropriate for autistic people (Bottema-Beutel et al., 2018). ...
Evidence suggest that autistic young people are vulnerable to feeling lonely, with detrimental consequences for their wellbeing. This systematic review sought descriptions of loneliness and connection by autistic young people. The findings summarise how loneliness has been conceptualised, measured and reported for autistic young people and offer a list of strategies that are personally meaningful and promote connection and wellbeing. Three conclusions are reached: first, there is a paucity of research on how this group experience loneliness; second, descriptions of feeling connected are mostly limited to neuronormative descriptions of friendship, which can judge autistic behaviours as inadequate; third, loneliness must be reconceptualised, and appropriate assessment tools developed. These developments should be supported by research with participation of the autistic community.
... The results showed a significant improvement in social skills and cooperation after participating in the play therapy program. Another study examined the effectiveness of Lego-based play therapy in improving social skills and cooperation in children with autism spectrum disorders (Lindsay et al., 2017). The research found that play therapy using Lego significantly improved social skills and cooperation in autistic children. ...
This research aims to analyze the implementation of play therapy embedded in play activities in Kindergarten B children at Lintang Kindergarten Surabaya. Play therapy is a therapeutic activity given to children to overcome problems related to cooperation, socialization and emotions. This play therapy approach places more emphasis on non-verbals. This means that children aged 2 to 12 years can freely express the feelings they experience, through playing with toys, sand, dolls, clay, art, dance and natural music. This research uses descriptive qualitative research methods. The research population was PAUD PG teachers at Lintang Kindergarten Surabaya. The research sample consisted of 2 teachers who taught class B. The choice of class B teachers was because, from the results of observations made, problems related to student socialization most often emerged in class B. The results of the research concluded that with play therapy, children become it is easier to express his feelings, becomes more relaxed and happy.
... Previous research has proven that Lego® therapy effectively improves social interaction, including increases in initiating social interaction, increases in the duration of dialogue exchanges, increased spatial vocabulary, decreases in negative perspectives with siblings and peers (LeGoff, 2004;MacCormack et al., 2015;Peckett et al., 2016;Brey, 2017;Lindsay et al., 2017). ...
One of the main characteristics of Autism Spectrum Disorder (ASD) is difficulty with social interaction, and research has shown that current social interventions may not be adequate to meet the needs of children with ASD in mainstream schools. Lego-based therapy is a peer-based social intervention which aims to improve social and communication skills for children with ASD. This intervention had been brought into Malaysia, but a limited evidence base has been developed. This study employed the structure and concept of Lego-based therapy in Lego® Bricks Play sessions. An AB Single-case research design was used to evaluate the effectiveness of the intervention in improving the social interaction of children with ASD. The study was run in the special needs education integration program in a public primary school. Two students with ASD were involved in this study. The intervention sessions were conducted three sessions per week 57 with three baselines and seven interventions sessions. The data of each session were collected during 15-minute free-play Lego sessions. The sessions were video recorded for data analysis according to a social behaviour coding scheme. Visual and statistical analyses such as Percentage of data points Exceeding the Median (PEM) and Tau-U calculation were used to analyse the data. Results indicated that both children with ASD increased their social initiations and responses, increased positive social behaviours, and decreased negative social behaviours. The study concludes that Lego® Bricks Play sessions effectively improve the social interactions of children with ASD.
... Lego therapy (LeGoff et al., 2014) is a targeted intervention, described as collaborative play therapy and there is a growing evidence-base for its efficacy in developing social skills in youth with autism. However, a scoping review suggested that although the evidence is promising, more research is required around programme outcomes and implementation (Lindsay et al., 2017), therefore it could not yet be described as an evidence-based intervention. It is a small group social skills intervention during which a trained adult teaches and facilitates social interactions between the pupils where pupils assume one of three roles. ...
Schools are increasingly encouraged to adopt evidence‐based or evidence informed interventions and implement them using insights from implementation science. The literature relating to implementation of interventions in schools has focused largely on universal interventions, particularly for social and emotional learning (SEL), which are designed for all children and young people. In contrast, targeted interventions provide additional support for those pupils who may require small group or individual support over and above that provided at the universal level. To date there has been limited consideration of factors which are important for the implementation of targeted SEL interventions. Data from an exploratory case study with two schools implementing Lego therapy are used to illustrate the implementation factors relevant to this targeted intervention. Findings indicate similarities in universal and targeted intervention core components and factors but also a number of distinct elements that are important to consider when implementing Lego therapy and potentially other targeted SEL interventions. Key considerations include the interaction with the wider school system, the pivotal role of the intervention champion, and the importance of external support for problem solving and sustainability. The resulting model may inform further development of implementation frameworks for Lego therapy and other targeted SEL interventions.
... • Has been used in conjunction with LEGO Robotics and to improve computational thinking (Lindsay et al., 2017;Yuen et al., 2014). ...
This concurrent session showcases a STEAM Makerspace curriculum, integrating innovative technologies with entrepreneurship, implemented at a K12 independent school for students with learning differences. The class, which consists of weekly challenges, project-based learning and fabrication practices culminates in a Maker Faire, featuring student products, given patronage by parents and the school community, helping students realize roles that their ideas could play in improving lives within communities they inhabit. In this session we first contextualize making as a social, economic and technological movement. Secondly, we describe the technologies we use in our classes, conduct a demo in the Homestyler tool, which is commonly used by architects to showcase examples of a home design activity we implement in the classroom. Thirdly, we situate our curriculum within a cultural-historical psychology framework and show how we progressively heighten students' practical competence with deploying projects using innovative educational technologies.
... As some evidence proves, LEGOtype robot kits can be quite successful even among kindergarteners (Kazakoff et al., 2013). Low-complexity building work aligns perfectly with children's natural interest in play and creating (Lindsay et al., 2017), so robotics construction sets have even been used as behavioral therapy (Narzisi et al., 2021). Incentivizing this propensity motivates young learners to actively discover and construct knowledge (Marouani, 2022). ...
p style="margin-left: 21.3pt; text-align: justify;">In recent years, educational robotics has gained ground in educational policy around the world, and primary education is no exception. However, there has not yet been a thorough synthesis of methodologically appropriate empirical research on the effects of robotics upon cognitive performance among primary school students, which this paper attempted to do. Following literature screening, a total of eight studies published between 2018 and 2022 with a sample size of 567 children met inclusion criteria and were meta-analyzed. Resultantly, a medium aggregate effect size in favor of robotics experiments emerged (standardized mean difference of .641), which was significantly higher compared to non-robotics learning (p <.01). No between-study heterogeneity was detected. Subgroup analysis revealed a slightly larger overall effect for interventions on first- to third-graders rather than those in grades 4-6. Additionally, the analysis indicates that in order to enhance cognitive abilities in primary students, robotics interventions should be no longer than four weeks and involve robot construction. Based on the findings, implications, and suggestions are outlined for future research and practice.</p
... • Has been used in conjunction with LEGO Robotics and to improve computational thinking (Lindsay et al., 2017;Yuen et al., 2014). ...
This concurrent session showcases a STEAM Makerspace curriculum cumulative to an upper school level, integrating innovative technologies with entrepreneurship, implemented at an independent neurodiverse independent school. The class culminated in a Maker Faire, featuring student products, given patronage by parents and the school community, helping students realize roles that their ideas could play in improving lives within communities they inhabit. Our curriculum allows:
1) Tinkering with concrete objects/models using digital technologies like Scratch, Tinker CAD, ClassVR, 3-D printers, laser cutters, and microprocessors,
2) exercising design thinking to prototype and test efficacy of products,
3) acquiring real-life skills to create/deploy business ideas, and
4) understanding how to engage in goal-oriented collaboration.
We outline a theoretical framework guiding the creation of a Makerspace curriculum, conduct a group challenge to view TinkerCAD models in Mergecubes, and visually showcase example student projects.
... Also, for several years now, work has been done on new therapies for improving inclusion and social skills among children and youth with autism. Two commonly used elements to attain these objectives are Lego therapy [19] and music [36]. A system based on Lego, which allows creating music in an interactive and collaborative way, as the one presented in this paper, can be very useful for the treatment of children and youngsters with autism. ...
In this paper, a system to build music in an intuitive and accessible way, with Lego bricks, is presented. The system makes use of the new powerful and cheap possibilities that technology offers for making old things in a new way. The Raspberry Pi is used to control the system and run the necessary algorithms, customized Lego bricks are used for building melodies, custom electronic designs, software pieces and 3D printed parts complete the items employed. The system designed is modular, it allows creating melodies with chords and percussion or just melodies or perform as a beatbox or a melody box. The main interaction with the system is made using Lego-type building blocks. Tests have demonstrated its versatility and ease of use, as well as its usefulness in music learning for both children and adults.
... Виявлено [1], що плавання та ігри у воді, біг та ходьба, імітація верхової їзди, елементи йоги та східних єдиноборств були ефективними фізичними заняттями для дітей з розладами аутичного спектра. Аналіз досліджень доводить, що заняття фізичними вправами із застосуванням ходьби та бігу [2], йоги [3], катання на конях [4], східних одноборств [5], плавання та аквафітнесу [6], рухливих ігор [7], ігор у настільний теніс [8], боулінг [9], LEGO [10] можуть призвести до вирішення численних поведінкових проблем, показників соціальної взаємодії та соціальної комунікації, пізнавальних процесів, підвищення фізичної підготовленості та формування психофізичних навичок та якості життя загалом школярів з розладами аутичного спектра. Проте невідомо які засоби застосовують під час індивідуальних уроків фізичної культури школярів з розладами аутичного спектра чи в інклюзивних класах в закладах загальної середньої освіти України. ...
Physical education is important for children with autism, as it contributes to their overall physical development, improvement of motor skills, social interactions, self-esteem and relaxation. The use of special means of physical education can significantly facilitate the learning process and the achievement of other goals of students with autism. Knowledge of physical education tools for schoolchildren with autism spectrum disorders is important for creating inclusive and effective physical education programs that support the development and well-being of this group of people. The goal is to conduct an analysis of special means of physical education of schoolchildren with autism spectrum disorders used by physical education teachers. We conducted a survey of physical education teachers (n=125) who conduct individual physical education lessons with schoolchildren with autism spectrum disorders or in inclusive classes in general secondary education institutions of Ukraine. The analysis of the obtained results showed that physical culture teachers of general secondary education institutions most often use elements of "traditional" types of motor activity: athletics (75%), games (80%) and gymnastics (90%). Conclusions. Means used in the physical education of children with autism spectrum disorders can be divided into two categories: traditional (games, gymnastics, swimming) and non-traditional for school physical education lessons (yoga, singing, hippotherapy, exergaming, weights). Physical education teachers use the tools of the first group more often during lessons. The following areas of application of special means of physical education for children with autism spectrum disorders can be distinguished: development of motor skills, social interaction, reduction of anxiety and stress, overcoming sensory overload.
... This social mediation of play objects is based on their physical affordances as well as emotional properties for the players, connecting children to their peers and the social world (Kibele, 2008;Williams et al., 2018). Including preferred play items can be effective in promoting social play for children and adolescents especially those with ASD (Boyd, et al., 2007;Dunst, et al., 2012;Gunn & Delafield-Butt, 2015;Kaboski et al, 2014;Koegel et al., 2012;Koegel, Kim, Koegel, & Schwartzman, 2013;Kryzak, Bauer, Jones, & Sturmey, 2013;Kryzak & Jones, 2014;Lindsay, et al., 2017;Vismara & Lyons, 2007;Watkins, O'Reilly, Kuhn, & Ledbetter-Cho, 2019;Wimpory, Hobson, & Nash, 2007). ...
Although theoretically any space can become a space for play to occur, certain spaces are more conducive for play than others. For a child with a disability, some spaces can present significant barriers to play. In these cases, occupational therapy practitioners promote the development of play spaces that foster and encourage play, through specific environmental modifications as well as training of key adults or peers. Occupational therapy practitioners address the physical environment’s safety, usability, and spatial arrangement and the personal relevance of specific environments and objects in them, as well as the influence of the social environment, to promote inclusive opportunities to play. Using direct and indirect interventions, practitioners apply their knowledge to help families, children, and others select playful play spaces, adapt play spaces to become more apt to promote play, and advocate for policy changes that promote greater access to playful spaces. This chapter highlights very specific strategies to promote play through explicit attention to many aspects of the environment for play.
... Similar to leveraging shared interests, interest-based activities enable the development of social and communication skills (Ashbaugh et al., 2017;Campbell & Tincani, 2011;Daubert et al., 2014;Dunst et al., 2012;R. L. Koegel et al., 2018;Lindsay et al., 2017). ...
Strength-based programs that incorporate technology have gained increasing popularity as an approach to improve outcomes for individuals with autism spectrum disorder (ASD). Despite this, the core elements of strength-based technology programs remain poorly described. This study aimed to identify the core elements of strength-based technology programs for youth with ASD through a systematic review of the literature. Electronic databases were searched for qualitative studies delivering strength-based technology-driven interventions to youth on the spectrum. Ten of the 874 studies identified met the criteria. Qualitative analysis revealed three core elements of strength-based technology programs for this population: mutual respect, demonstrating skills, and interests. The findings underpin the design of future strength-based technology programs for youth with ASD.
... Play is the most important occupation for children because it contributes to all areas of child development and facilitates the acquisition of the performance skills required for activities of daily living. In addition, in adolescents, play is also a way to improve different ASD-behaviors, family relationships as well as socialization and communication skills (Lindsay et al., 2017). Play absence or impairment can, therefore, impact negatively on their occupational performance in adult life (Blázquez-Ballesteros et al., 2015). ...
New technologies (NT) are increasingly used in Occupational Therapy (OT) interventions in people with Autism Spectrum Disorder (ASD). We conducted a scoping review to describe OT interventions investigated in scientific literature which use NT in children and adolescents with ASD. Two authors independently searched the scientific databases PubMed, EMBASE, Scopus and Web of Science, carried out a peer-review screening of articles and extracted data. Twenty studies met the inclusion criteria. OT interventions lasted between 1 week and 12 months, consisted of between 1 session per day and 5 sessions per week, were carried out exclusively by an occupational therapist, and the most used NT was the computer (n = 12). The duration of the interventions and assessment measures used varied greatly between studies.
... In addition, from the academic directives, it is established that in each school year an institutional activity called Isidriana Week is carried out, which generally takes place in September, in which cultural activities are developed where plays, dances, reading space, poetry among others are presented; also sports competitions are held between different school grades in micro soccer, volleyball, and chess. An important point of this Isidriana week is the participation of the community where some students can present to the academic community some work done in some subjects such as physics, chemistry, mathematics, entrepreneurship, among others [11,12]. ...
This article explains details of the participation in the Science Fair that took place in
the 2019 school year by some seventh-grade students from “Colegio Isidro Caballero Delgado”,
Floridablanca, Colombia. This event is a space established by the institution, which takes place
once a year to show different projects and experiments carried out by students from each of the
school grades. The seventh-grade students for their participation took as their theme an
Amusement Park; with this theme, they built different prototypes that resemble mechanical
attractions using LEGO Education cards and applying STEAM. The aim is to explain different
themes seen in the mathematics course during the year playfully and amusingly to the
participating public through the operation of each of these prototypes and physics topics in its
structure or operation. The structure of the document contains a first section, the introduction in
which the context of the educational institution, the development of the science fair, and the use
of LEGO Education cards for the 2019 version are addressed; a section II where the methodology
and the applied strategy are detailed; in section III the results obtained are mentioned, and finally,
in section IV the conclusions and possible recommendations are presented.
... These tasks were selected along with psychologists due to the variety of individual and dyadic behaviors they elicit. In particular, Lego structures have been widely used in observational settings to assess aspects as communication [74], social skills [75] or teamwork abilities and performance [76]. Ghost and Animals are examples of board games, proven to be valid assessments of interpersonal skills [77,78]. ...
... Autism & Developmental Language Impairments Reviews investigating non-play outcomes relating to social and communication development have focused on specific therapeutic approaches. For example, Lindsay et al. (2017) investigated the evidence for LEGO Therapy, while Tiede and Walton investigated Naturalistic Developmental Behavioral Interventions (NDBIs;Tiede & Walton, 2019). ...
Background and aims:
Play is used by practitioners from across disciplinary backgrounds as a natural and enjoyable context for providing intervention and support in early childhood. In the case of autism interventions, many therapies are based on the association between social play and the development of social skills, language development, and communication skills, as these are often particular areas of challenge for autistic children. However, play is a wide-ranging concept and the extant literature on play-based interventions is large and heterogeneous. This means it is challenging for practitioners and families to navigate the evidence base and make choices about differing intervention strategies. This review aims to provide a comprehensive map of the research on this topic and to develop a conceptual framework to inform clinical decision-making.
Methods:
An initial stakeholder consultation confirmed the relevance of the topic to practitioners and autistic people. A scoping review methodology (preregistered) was used to identify relevant literature. We systematically searched seven databases to find peer-reviewed primary intervention studies of play-based approaches targeting language, social and communication outcomes for autistic children aged 2-8 years. We then summarised the literature using narrative synthesis and Evidence Gap Maps (EGMs). The literature was summarised according to a range of characteristics, including study design, population characteristics, agent of intervention and outcomes measured, among others. These summaries were then used to develop a framework for some key considerations for practitioners appraising play-based approaches.
Results:
388 studies met inclusion criteria. Approximately 21% of studies were RCTs, and over 50% had ≤10 participants. Over 45% of studies reported multiple relevant outcomes, with social play skills being the most common single intervention target. Girls and minority background groups are under-represented. A range of intervention types were identified, and some high-level categorisations are proposed.Main contribution: On the basis of the evidence synthesis we suggest important dimensions for appraisal of play-based interventions, including the role of play within an intervention (as a context, a key developmental mechanism, or a component of a larger approach), the underpinning philosophy (e.g. behaviourist or developmental), and the role of the practitioner (providing parent feedback, 1:1 intervention, group facilitation).
Conclusions:
The wide range of approaches uncovered by this review is a testament to the wonderful diversity inherent to both play and autism. However, research could usefully focus on consolidating the evidence base for existing approaches, rather than aiming for further diversification. Implications: The conceptual framework proposed in this review can help practitioners appraise the literature and aid their advice to families when making shared intervention decisions.
Children with cerebral palsy (CP) typically exhibit lower fine motor skills compared to their typically developing peers. Various interventions, including constructive LEGO play, have been explored to support fine motor skill development. This study examines the effectiveness of constructive LEGO play in enhancing fine motor skills in children with CP at SDLB Putra Jaya Malang. A Single-Subject Design (SSD) with an A-B-A format was employed. Data were collected through structured observations and assessments of fine motor skills during baseline, intervention, and post-intervention phases. Findings indicate a notable improvement in fine motor skills from the first baseline (A1) to the intervention phase (B), with sustained progress in the second baseline (A2) after the intervention was withdrawn. This suggests that constructive LEGO play positively influences fine motor skill development in children with CP. The study highlights the potential of LEGO-based activities as an engaging and effective tool for improving fine motor coordination in children with CP. The observed progress reinforces the need for structured and repetitive fine motor activities in special education settings. Constructive LEGO play proves to be a beneficial intervention for enhancing fine motor skills in children with CP. Its integration into therapy and special education programs could provide long-term benefits. Further research is recommended to explore its scalability and long-term impact.
Autistic people frequently experience difficulties with friendships, peer victimization, social isolation, and significant loneliness. These social challenges can negatively impact mental health functioning and quality of life. To support youth in achieving connection and closeness with peers, social skills programs have been developed, tested, and determined to be beneficial for autistic youth. This chapter reviews a variety of social skills program approaches, with a focus on research conducted in the last decade, current best practices, and new advances. The current literature suggests that group social skills programs (GSSP) have the strongest evidence base in supporting autistic children and adolescents in improving social skill functioning and achieving social goals. Beyond GSSP, peer- and technology-mediated programs were also prominent and show promise but need larger replication studies with randomization, active control groups, and generalization probes. Although social skills programming is already classified as an evidence-based practice, continued research on social skills programs is critical, with the aims to better understand and refine curricula and delivery to be widely accessible, neuro-affirming, and responsive to the needs of diverse autistic youth.
Este artículo analiza cómo las marcas de juguetes dirigidas al público infantil integran los valores de inclusión y diversidad en su estrategia de producción y comunicación. Se evalúa además la cobertura periodística de estas iniciativas y se investiga la percepción de los compradores. Adoptamos una metodología empírico-analítica mediante el estudio de casos de seis marcas y una encuesta realizada a 316 participantes. Los principales resultados muestran que estas marcas han aumentado su enfoque en la representación de personas con discapacidad y en la inclusión racial y de género. Se concluye que las marcas de juguetes están respondiendo a la demanda de inclusión y diversidad en el mercado infantil, cuya relevancia social se plasma en su amplia cobertura mediática.
Background
China has a significant population of left-behind children, defined as those whose parents have migrated away from their home for at least six months. This situation arises when one or both parents leave to seek work in urban areas. Among the various challenges faced by left-behind children, social anxiety has emerged as one of the most pressing issues.
Objective
This study aims to deeply explore the impact of interactive video games and LEGO games on the social anxiety of rural left-behind children, with the aim of providing a more comprehensive and effective solution to the mental health problems they encounter.
Methods
Eighty-four rural left-behind children were randomly assigned to four groups: interactive video game group, LEGO game group, combined intervention group, and the control group, using a single-blind randomized controlled experiment. All participants underwent the intervention three times a week for 12 weeks. Social anxiety levels were assessed at three points: before the intervention (T0), immediately after the intervention (T1), and 6 weeks post-intervention (T2).
Results
The effects of different intervention strategies on the social anxiety of left-behind children showed significant group-time interaction effects. As the intervention progressed, the total score of social anxiety and the scores of various dimensions among participants in different intervention groups showed a gradual decreasing trend. The combined intervention group scored significantly lower at T1 and T2 than both the interactive video game group and the LEGO group.
Conclusion
Our findings indicate that social anxiety in left-behind children can be significantly mitigated through both LEGO therapy and interactive video games, with a combined approach yielding the most pronounced effects. These results underscore the importance of a multifaceted intervention strategy that addresses the unique social needs of this vulnerable population. Importantly, our study suggests that effective interventions should not only focus on symptom reduction but also foster environments that enhance social skills and build confidence. Future research should investigate the scalability of these interventions across diverse contexts and their potential integration into existing mental health services to better support left-behind children.
The objective of the current study was to assess how a LEGO intervention, implemented by a grandparent and a parent at home, affected social interactions for four children (two girls, two boys; ages 6–7 years) on the autism spectrum in China. A multiple probe design across four families was used. Grandparents and parents were trained to use effective teaching strategies in structured LEGO play activities to engage in interactions with their children. Results indicated that all four children’s spontaneous social initiations and responses were improved and maintained for at least 7 weeks following completion of the intervention. Increased social initiations and responses were generalized to family activities and free play at home.
Background
Social skills interventions are commonly recommended to help children and young people with autism spectrum disorder develop social skills, but some struggle to engage in these interventions. LEGO ® (LEGO System A/S, Billund, Denmark) based therapy, a group social skills intervention, aims to be more interesting and engaging.
Objective
To evaluate the clinical effectiveness of LEGO ® based therapy on the social and emotional skills of children and young people with autism spectrum disorder in school settings compared with usual support. Secondary objectives included evaluations of cost-effectiveness, acceptability and treatment fidelity.
Design
A cluster randomised controlled trial randomly allocating participating schools to either LEGO ® based therapy and usual support or usual support only.
Setting
Mainstream schools in the north of England.
Participants
Children and young people (aged 7–15 years) with autism spectrum disorder, their parent/guardian, an associated teacher/teaching assistant and a facilitator teacher/teaching assistant (intervention schools only).
Intervention
Schools randomised to the intervention arm delivered 12 weekly sessions of LEGO ® based therapy, which promotes collaborative play and encourages social problem-solving in groups of three children and young people with a facilitator (trained teacher or teaching assistant). Participants received usual support from school and community services. Participants in the control arm received usual support only. Research assistants and statisticians were blind to treatment allocation.
Main outcome measure
The social skills subscale of the Social Skills Improvement System (SSIS), completed by the children and young people’s unblinded teacher pre randomisation and 20 weeks post randomisation. The SSIS social skills subscale measures social skills including social communication, co-operation, empathy, assertion, responsibility and self-control. Participants completed a number of other pre- and post-randomisation measures of emotional health, quality of life, loneliness, problem behaviours, academic competence, service resource utilisation and adverse events.
Results
A total of 250 children and young people from 98 schools were randomised: 127 to the intervention arm and 123 to the control arm. Intention-to-treat analysis of the main outcome measure showed a modest positive difference of 3.74 points (95% confidence interval –0.16 to 7.63 points, standardised effect size 0.18; p = 0.06) in favour of the intervention arm. Statistical significance increased in per-protocol analysis, with a modest positive difference (standardised effect size 0.21; p = 0.036). Cost-effectiveness of the intervention was found in reduced service use costs and a small increase in quality-adjusted life-years. Intervention fidelity and acceptability were positive. No intervention-related adverse events or effects were reported.
Conclusions
The primary and pre-planned sensitivity analysis of the primary outcome consistently showed a positive clinical difference, with modest standardised effect sizes of between 0.15 and 0.21. There were positive health economics and qualitative findings, corroborated by the difference between arms for the majority of secondary outcomes, which were not statistically significant but favoured the intervention arm. Post hoc additional analysis was exploratory and was not used in drawing this conclusion. Given the small positive change, LEGO ® based therapy for children and young people with autism spectrum disorder in schools should be considered.
Limitations
The primary outcome measure was completed by an unblinded teacher (rather than by the facilitator).
Future work
The study team recommends future research into LEGO ® based therapy, particularly in school environments.
Trial registration
This trial is registered as ISRCTN64852382.
Funding
This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: 15/49/32) and is published in full in Public Health Research ; Vol. 11, No. 12. See the NIHR Funding and Awards website for further award information.
Objectives
Neurodiversity affirming frameworks are a paradigm shift from a deficit-focused approach to autism to recognizing autism as a heterogeneous constellation of differences in abilities and strengths. This article completed a literature review and data synthesis to (1) identify autistic strengths used in the design of psychosocial interventions, (2) propose mechanisms of change that explain strength-based psychosocial intervention effects on mental health and wellbeing outcomes, and (3) integrate findings in a conceptual model for testing in future research studies.
Methods
A search for articles was completed in June 2023 and resulted in 24 articles that met the inclusion criteria. The Distillation and Matching Model methods were used to code articles and subsequent conceptual groupings generated categorical domains included in the conceptual model.
Results
Autistic strengths identified in the design of psychosocial interventions were grouped into four domains: (1) perceptual, (2) reasoning, (3) expertise, and (4) character strengths. Mechanisms of change were grouped into four domains: (1) affective, (2) behavioral, (3) cognitive, and (4) physiological. The resulting conceptual model presents autistic strengths that can be leveraged in psychosocial interventions and potential mechanisms of change that explain intervention effects on mental health and wellbeing.
Conclusions
Growing focus on the translation of positive psychology has resulted in strength-based psychosocial intervention programs. However, intervention strategies have not leveraged the diverse array of autistic strengths identified by autistic individuals, their families, and their communities. Furthermore, research is needed to determine mechanistic paths by which strength-based interventions achieve positive effects on mental health outcomes in autistic children and adolescents.
Introduction: Autism spectrum disorder (ASD) is a developmental neurological disorder that threatens individuals’ social interactions and communication by limiting their activities and personal interests.
Aim: The present study aimed to assess the effectiveness of compassion-focused therapy in helping attitudes and the work-related flow of autism child mentors in the rehabilitation centers of Mazandaran, Iran.
Method: The research method was a quasi-experimental study with a pretest-posttest, control group, follow-up design. The sample population included all male and female mentors of autistic children in the rehabilitation centers of Mazandaran in 2020. In total, 30 mentors were selected by voluntary sampling and divided into a test and a control group by simple random sampling (15 per group). Eight sessions of therapeutic intervention were provided to the study groups. Post-test and follow-ups were conducted for both groups after therapy. Data were collected using Nickell’s Helping Attitude Scale (1998) and Bakker’s Work-Related Flow Scale (2008). Data analysis covariance analysis was performed in SPSS version 25.
Results: Findings demonstrated a significant difference between the mean scores of the test and control groups regarding helping attitudes and work-related flow among autism child mentors in the post-test stage (p
Social learning through friendships is important in child development. Autistic children often initiate and engage in social interactions differently than neurotypical peers. LEGO® based therapy is a group intervention which facilitates social interactions with peers using collaborative LEGO® play. A 1:1 cluster randomised controlled trial with autistic children aged 7–15 comparing 12 weeks’ LEGO® based therapy and usual support to usual support alone in 98 mainstream schools (2017–2019) was carried out. The primary outcome was social skills (Social Skills Improvement System) completed by unblinded teachers (not intervention deliverers) at 20 weeks. Analysis used intention-to-treat. Fifty intervention schools (127 participants) and 48 control schools (123 participants) were allocated. Primary analysis included 45 intervention schools (116 participants) and 42 control schools (101 participants). The between-arms difference was 3.74 (p = 0.06, 95% confidence interval: −0.16, 7.63) and 1.68 (p = 0.43, 95% confidence interval: −2.51, 5.87) at 20 and 52 weeks (0.18 and 0.08 standardised effect sizes). Twenty-week outcomes for those receiving per protocol intervention were 4.23 (95% confidence interval 0.27, 8.19) with a standardised effect size of 0.21. Sensitivity estimates were between 3.10 and 4.37 (0.15–0.21 standardised effect sizes). Three unrelated serious adverse events were reported. LEGO® based therapy has a small positive non-significant benefit for social skills at 20 weeks but not 52 weeks.
Lay abstract
Autism is characterised by keen interests and differences in social interactions and communication. Activities that help autistic children and young people with social skills are commonly used in UK schools. LEGO® based therapy is a new activity that provides interesting and fun social opportunities for children and young people and involves building LEGO® models together. This study looked at LEGO® based therapy for the social skills of autistic children and young people in schools. It was a randomised controlled trial, meaning each school was randomly chosen (like flipping a coin) to either run LEGO® based therapy groups in school over 12 weeks and have usual support from school or other professionals, or only have usual support from school or other professionals. The effect of the LEGO® based therapy groups was measured by asking children and young people, their parents/guardians, and a teacher at school in both arms of the study to complete some questionnaires. The main objective was to see if the teacher’s questionnaire answers about the children and young people’s social skills changed between their first and second completions. The social skills of participants in the LEGO® based therapy groups were found to have improved in a small way when compared to usual support only. The study also found that LEGO® based therapy was not very costly for schools to run and parents/guardians and teachers said they thought it was good for their children and young people. We suggest further research into different potential benefits of LEGO® based therapy.
Purpose:
The present study aimed to compare the effectiveness of music and playing with Lego in postoperative management pain in children.
Design and methods:
In this three-group quasi-experimental study, the participants in this interventional study were 96 children aged 6 to 12 years admitted to the pediatric surgery ward of Mofid Hospital and Medical Center in Tehran. The participants were selected using convenience sampling. They were then randomly placed into three intervention groups. Pain intensity was measured for the participants in all three groups before the intervention. The intervention was performed in two 15-min sessions with an interval of 5 min in three intervention groups. Then pain intensity was measured using the Oucher Pain Scale before the intervention and in four intervals: Immediately after the intervention, half an hour, one hour, and 3 h after the intervention, respectively. Pain intensity was also measured at the same time intervals for the participants in the control group. The collected data were analyzed with SPSS-25 software using descriptive statistics, the Bonferroni test, and Tukey's test.
Results:
The data showed that the three groups were identical in terms of demographic characteristics (p > 0.05).A comparison of the music listening group and the control group showed statistically significant difference in terms of postoperative pain (P < 0.05).However, the data showed significant differences between the control group and the Lego group in terms of pain intensity immediately after the intervention, half an hour, one hour, and 3 h after the intervention, respectively (p < 0.05).The data also revealed a significant difference between the children in the music group and the Lego group at all phases (p < 0.05), and the children in the Lego group reported less pain after the intervention compared to the children in the music listening group. Nevertheless, there was a statistically significant difference between the three groups in terms of reported pain intensity half an hour, one hour, and three hours after the intervention (p < 0.05).
Conclusion:
The results showed that playing with Legos had a greater effect on reducing postoperative pain in children than listening to music. Thus, nurses are recommended to make arrangements for children to play with Legos after surgery.
Practice implication:
Playing with Legos can be used to control postoperative pain in school-age children in medical centers and wards of pediatric hospitals.
Congenital heart disease is defined as an abnormality in the cardiocirculatory structure or function. Various studies have shown that patients with this condition may present cognitive deficits. To compensate for this, several therapeutic strategies have been developed, among them, the LEGO® Education sets, which use the pedagogic enginery to modify cognitive function by didactic material based on mechanics and robotics principles. Accordingly, the goal of this study was to evaluate the effect of cognitive habilitation by using LEGO®-based therapy in pediatric congenital heart disease patients. This was a quasi-experimental study; eligible patients were identified, and their general data were obtained. In the treatment group, an initial evaluation with the neuropsychological BANFE-2 test was applied; then, once a week, the interventions were performed, with a final test at the end of the interventions. In the control group, after the initial evaluation, a second appointment was scheduled for the final evaluation. Our results show that >50% of children presented cognitive impairment; nevertheless, there was an overall improvement in treatment patients, showing a significant increase in BANFE scores in areas related to executive functions. LEGO®-based therapy may be useful to improve cognitive abilities; however, future research should be performed to strengthen the data.
Chapters in this book have described a number of intervention procedures that are empirically supported strategies for social skills teaching. Although these interventions have well-defined steps for implementation, use in applied settings typically required the clinician to independently develop all intervention materials that would be used with a learner. Unlike these teaching strategies, manualized social skills curricula provide a clinician with all requisite materials for social skills teaching. Further, many manualized social skills curricula are composed of other social skills teaching strategies discussed elsewhere in this book. Subsequently, manualized curricula are often noted to have benefits in terms of reducing barriers to implementation of evidence-based practices. The purpose of this chapter is to provide a description of frequently researched and utilized manualized social skills curricula, with a particular emphasis on the individual social skills teaching strategies that compose the curricula. Further, a review of the empirical support of commonly used social skills curricula is provided as a means of guiding clinician selection of an appropriate curriculum.
The historical, anthropological and developmental research shows that play has been universal in all cultures, and children's play is supported by toys and play materials produced by adults. Children are prepared to learn what they need to learn with passion and pleasure, and quality toys when used appropriately provide children with a wealth of opportunities for creativity, social interaction with adults, and effective participation. Throughout history, children's play has undergone various changes due to cultural, political and socioeconomic factors without losing its virtues and importance. Therefore, research-based evidence on specific types of play and toys which support learning and development most effectively needs to be multiplied. This text emphasizes the aspects of toys related to creativity. Relevant to our day, the threats to the place of play and toy in the life of the increasingly lonely child are also discussed.
Purpose: The aim of this study was to explain the effectiveness of the model of established methods in autism (functional behavior analysis of ABA, Snowlen, and Dosa) based on the level of attention in children with autism spectrum disorder in Tehran.
Methodology: The research method was quasi-experimental with a pretest-posttest design with a control group. The statistical population of this study was all children with autism spectrum disorder in Tehran in public and private educational and rehabilitation centers in 2018. By available sampling method, 48 people were selected and randomly divided into 4 intervention groups by applied behavior analysis method. , Snozelen, dosa and control group were divided. Data were collected based on the Connors Scale Scale (Parent Form) (1999), a modified review checklist, and the Wechsler intelligence test. Descriptive and inferential statistical methods and multivariate analysis of covariance were used to eliminate the pretest effect using SPSS software was used.
Findings: The results showed that all three methods of functional behavior analysis of ABA, Snozlen and Dosa had a significant effect on increasing attention compared to the control group. Also, ABA applied behavior analysis method had a greater effect on improving attention in the three measurement stages than the other two experimental groups.
Conclusion: The findings of the study showed that the use of these interventions and educational programs as a method in improving and rehabilitating children with this disorder is useful, so the use of this method is recommended. The results showed that the difference between the analysis of functional behavior of ABA, Snozlen and Dosa with the control group was significant at the level of 0.05, so it can be said that all three methods of functional behavior analysis of ABA, Snozlen and Dosa compared to the control group had a significant effect on increasing attention.
This study aimed to explore mothers’ experience of implementing Lego Therapy at home within the family. Following a Lego Therapy training session, mothers carried out hourly sessions with their child with an autism spectrum condition and the child’s sibling, once a week, for 6 weeks. Mothers were interviewed following the intervention, and the data were analysed using interpretative phenomenological analysis. Themes emerged around improved family relationships, a positive impact on the child as an individual, and changed maternal, sibling and child perspectives. Challenging and facilitative aspects also emerged, as did some ambivalence about the impact of the intervention in the wider context. The findings are supportive of previous Lego Therapy studies and have implications for strengths-based service provision.
Clinical interventions have been effective at increasing social skills of youth with autism spectrum disorder (ASD). However, generalization of those skills to non-clinical environments is often low. To reduce this generalization gap, community-based programs have been designed to help youth develop social skills in naturalistic settings. This paper describes a community-based social-skills intervention for youths with ASD aged 7–12, which was designed to build on the findings of a previous study. In this program, youths with ASD cooperated with siblings and peers in structured and unstructured play over the course of four weeks. The researchers conducted extensive observations of the play by the youths and conducted interviews with the youths with ASD, their parents, and program staff. Both in our observations and in the perceptions of the parents, the youths with ASD increased their play and socialization. Using Vygotsky's (1978) socio-cultural theory as a guiding framework, we describe the components of this intervention that contributed to the This Article (Subscription-only) is brought to you by Scholarship@Western. It has been accepted for inclusion in Exceptionality Education International by an authorized administrator of Scholarship@Western. For more information, please contact jspecht@uwo.ca.
The aim of the study was to investigate the effectiveness of a brief robot-mediated intervention based on Lego(®) therapy on improving collaborative behaviors (i.e., interaction initiations, responses, and play together) between children with ASD and their siblings during play sessions, in a therapeutic setting. A concurrent multiple baseline design across three child-sibling pairs was in effect. The robot-intervention resulted in no statistically significant changes in collaborative behaviors of the children with ASD. Despite limited effectiveness of the intervention, this study provides several practical implications and directions for future research.
To utilise the knowledge gained from highly specialised domains as autism therapy to robot-based interactive training platforms, an innovative design approach is needed. We present the process of content creation and co-design of LEGO therapy for children with autism spectrum disorders performed by a humanoid robot. The co-creation takes place across the disciplines of autism therapy, and behavioural robotics, and applies methods from design and human–robot interaction, in order to connect state-of-the-art developments in these disciplines. We designed, carried out and analyzed a pilot and final experiment, in which a robot mediated LEGO therapy between pairs of children was mediated by a robot over the course of 10 to 12 sessions. The impact of the training on the children was then analysed from a clinical and human–robot interaction perspective. Our major findings are as follows: first, game-based robot scenarios in which the game continues over the sessions opened possibilities for long-term interventions using robots and led to a significant increase in social initiations during the intervention in natural settings; and second, including dyadic interactions between robot and child within triadic games with robots has positive effects on the children's engagement and on creating learning moments that comply with the chosen therapy framework.
This article describes the use of social-story intervention programs to teach appropriate social behavior to 3 children with autism. The procedures used in these interventions combined social-story methodology with a more traditional behavioral social-skills training strategy. Procedures and suggestions for successfully developing, implementing, and evaluating social-story intervention programs are also provided.
Investigating social participation of young adults with an autism spectrum disorder (ASD) is important given the increasing number of youth aging into young adulthood. Social participation is an indicator of life quality and overall functioning. Using data from the National Longitudinal Transition Study 2, we examined rates of participation in social activities among young adults who received special education services for autism (ASD group), compared to young adults who received special education for intellectual disability, emotional/behavioral disability, or a learning disability. Young adults with an ASD were significantly more likely to never see friends, never get called by friends, never be invited to activities, and be socially isolated. Among those with an ASD, lower conversation ability, lower functional skills, and living with a parent were predictors of less social participation.
This article aims to introduce how Lego project can help young children with autism spectrum disorder (ASD) improve social interaction and language skills and reduce challenging behaviors. A case study of a preschooler named Adam with mild ASD characteristics such as language delays, behavioral problems and lack of social interaction was introduced, followed by a detailed narration of the intervention sessions using Lego games. A series of self-developed observation checklists were used to monitor Adam's social emotional development, language development, challenging behaviors as well as fine motor skill development. After three Lego-intervention sessions Adam increases his social interactions with peers, has more eye contact, starts to share materials with his friends, expresses his interest in playing with peers, and improves his verbal communication ability. Besides Lego game, other constructive play materials also can be used to improve Adam and other young children's with ASD language skills and social competence. The Lego-intervention therapy is also beneficial to typically developing peers in that it can help the development of imagination, creativity and team work.
Scoping studies are an increasingly popular approach to reviewing health research evidence. In 2005, Arksey and O'Malley published the first methodological framework for conducting scoping studies. While this framework provides an excellent foundation for scoping study methodology, further clarifying and enhancing this framework will help support the consistency with which authors undertake and report scoping studies and may encourage researchers and clinicians to engage in this process.
We build upon our experiences conducting three scoping studies using the Arksey and O'Malley methodology to propose recommendations that clarify and enhance each stage of the framework. Recommendations include: clarifying and linking the purpose and research question (stage one); balancing feasibility with breadth and comprehensiveness of the scoping process (stage two); using an iterative team approach to selecting studies (stage three) and extracting data (stage four); incorporating a numerical summary and qualitative thematic analysis, reporting results, and considering the implications of study findings to policy, practice, or research (stage five); and incorporating consultation with stakeholders as a required knowledge translation component of scoping study methodology (stage six). Lastly, we propose additional considerations for scoping study methodology in order to support the advancement, application and relevance of scoping studies in health research.
Specific recommendations to clarify and enhance this methodology are outlined for each stage of the Arksey and O'Malley framework. Continued debate and development about scoping study methodology will help to maximize the usefulness and rigor of scoping study findings within healthcare research and practice.
Systematic reviews and meta-analyses are essential to summarize evidence relating to efficacy and safety of health care interventions accurately and reliably. The clarity and transparency of these reports, however, is not optimal. Poor reporting of systematic reviews diminishes their value to clinicians, policy makers, and other users.
Since the development of the QUOROM (QUality Of Reporting Of Meta-analysis) Statement—a reporting guideline published in 1999—there have been several conceptual, methodological, and practical advances regarding the conduct and reporting of systematic reviews and meta-analyses. Also, reviews of published systematic reviews have found that key information about these studies is often poorly reported. Realizing these issues, an international group that included experienced authors and methodologists developed PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) as an evolution of the original QUOROM guideline for systematic reviews and meta-analyses of evaluations of health care interventions.
The PRISMA Statement consists of a 27-item checklist and a four-phase flow diagram. The checklist includes items deemed essential for transparent reporting of a systematic review. In this Explanation and Elaboration document, we explain the meaning and rationale for each checklist item. For each item, we include an example of good reporting and, where possible, references to relevant empirical studies and methodological literature. The PRISMA Statement, this document, and the associated Web site (http://www.prisma-statement.org/) should be helpful resources to improve reporting of systematic reviews and meta-analyses.
Systematic reviews and meta-analyses are essential to summarise evidence relating to efficacy and safety of healthcare interventions accurately and reliably. The clarity and transparency of these reports, however, are not optimal. Poor reporting of systematic reviews diminishes their value to clinicians, policy makers, and other users.
Since the development of the QUOROM (quality of reporting of meta-analysis) statement—a reporting guideline published in 1999—there have been several conceptual, methodological, and practical advances regarding the conduct and reporting of systematic reviews and meta-analyses. Also, reviews of published systematic reviews have found that key information about these studies is often poorly reported. Realising these issues, an international group that included experienced authors and methodologists developed PRISMA (preferred reporting items for systematic reviews and meta-analyses) as an evolution of the original QUOROM guideline for systematic reviews and meta-analyses of evaluations of health care interventions.
The PRISMA statement consists of a 27-item checklist and a four-phase flow diagram. The checklist includes items deemed essential for transparent reporting of a systematic review. In this explanation and elaboration document, we explain the meaning and rationale for each checklist item. For each item, we include an example of good reporting and, where possible, references to relevant empirical studies and methodological literature. The PRISMA statement, this document, and the associated website (www.prisma-statement.org/) should be helpful resources to improve reporting of systematic reviews and meta-analyses.
In the last few years, there has been an increasing amount of research showing the concurrent and long-term consequences of bullying and being bullied by peers. OBJECTIVE. We performed a meta-analysis to quantify the association between involvement in bullying and psychosomatic complaints in the school-aged population.
We searched online databases (Embase, Medline, PsychInfo, Scopus) up to March 2008, bibliographies of existing studies, and qualitative reviews for studies that examined the association between involvement in bullying and psychosomatic complaints in children and adolescents. The original search identified 19 studies, of which 11 satisfied prestated inclusion criteria.
Three random-effects meta-analyses were performed for the following 3 groups of children aged between 7 and 16 years: victims, bullies, and bully-victims. Bully-victims, victims, and bullies had a significantly higher risk for psychosomatic problems compared with uninvolved peers.
The association between involvement in bullying and psychosomatic problems was demonstrated. Given that school bullying is a widespread phenomenon in many countries around the world, the present results suggest that bullying be considered a significant international public health issue.
A repeated-measures, waiting list control design was used to assess efficacy of a social skills intervention for autistic spectrum children focused on individual and group LEGO play. The intervention combined aspects of behavior therapy, peer modeling and naturalistic communication strategies. Close interaction and joint attention to task play an important role in both group and individual therapy activities. The goal of treatment was to improve social competence (SC) which was construed as reflecting three components: (1) motivation to initiate social contact with peers; (2) ability to sustain interaction with peers for a period of time: and (3) overcoming autistic symptoms of aloofness and rigidity. Measures for the first two variables were based on observation of subjects in unstructured situations with peers; and the third variable was assessed using a structured rating scale, the SI subscale of the GARS. Results revealed significant improvement on all three measures at both 12 and 24 weeks with no evidence of gains during the waiting list period. No gender differences were found on outcome, and age of clients was not correlated with outcome. LEGO play appears to be a particularly effective medium for social skills intervention, and other researchers and clinicians are encouraged to attempt replication of this work, as well as to explore use of LEGO in other methodologies, or with different clinical populations.
LEGO© building materials have been adapted as a therapeutic modality for increasing motivation to participate in social skills intervention, and providing a medium through which children with social and communication handicaps can effectively interact. A 3 year retrospective study of long-term outcome for autistic spectrum children participating in LEGO© therapy (N = 60) compared Vineland Adaptive Behavior Scale socialization domain (VABS–SD) and Gilliam Autism Rating Scale social interaction subscale (GARS–SI) scores preand post-treatment with a matched comparison sample (N = 57) who received comparable non-LEGO© therapy. Although both groups made significant gains on the two outcome measures, LEGO© participants improved significantly more than the comparison subjects. Diagnosis and pre-treatment full-scale IQ scores did not predict outcome scores; however, Vineland adaptive behavior composite, Vineland communication domain, and verbal IQ all predicted outcome on the VABS–SD, especially for the LEGO© therapy group. Results are discussed in terms of implications for methods of social skills intervention for autistic spectrum disorders.
Facilitating the learning and participation of pupils with Asperger syndrome and high-functioning autism (herein referred to as AS) in mainstream schools is complex and poorly understood. We report on a small-scale qualitative study of the views and experiences of 20 such pupils drawn from four secondary schools in north-west England. Data were collected through semi-structured interviews and pupil diaries. Interpretive phenomenological analysis was used to explore how pupils with AS make sense of their educational experiences. The central theme was how participants constructed their understanding of what their AS meant to them. This was often characterized by negative perceptions of their differences, such as being `retarded' or having a `bad brain'. The links between this understanding and reported difficulties with peers and teachers, the desire to `fit in', and other themes are discussed. The implications of these findings for policy and practice in this area are also presented.
LEGO therapy and the Social Use of Language Programme (SULP) were evaluated as social skills interventions for 6-11 year olds with high functioning autism and Asperger Syndrome. Children were matched on CA, IQ, and autistic symptoms before being randomly assigned to LEGO or SULP. Therapy occurred for 1 h/week over 18 weeks. A no-intervention control group was also assessed. Results showed that the LEGO therapy group improved more than the other groups on autism-specific social interaction scores (Gilliam Autism Rating Scale). Maladaptive behaviour decreased significantly more in the LEGO and SULP groups compared to the control group. There was a non-significant trend for SULP and LEGO groups to improve more than the no-intervention group in communication and socialisation skills.
Developmental Issues for the School-Age Child With Autistic Spectrum Disorder Psychiatric And Behavioral Problems Examples of Development in the School-Age Child With Autistic Spectrum Disorder Conclusion
This article describes lego therapy club within a Child and Adolescent Mental Health Service (CAMHS) setting. Children with a diagnosis of autism spectrum disorder (ASD) were invited to attend an eight week Lego Therapy Club to improve social skills with peers.
This study presents an evaluation of the Lego® Therapy intervention (LeGoff, 2004) for six children, aged six to ten, with varying social communication difficulties. Lego® Therapy is a small-group, child-led and peer-based social development programme. Relevant theory and existing literature is explored firstly, before a systematic review of social communication intervention evaluations is presented. This is followed by a review of current Lego® Therapy studies, highlighting the limited evidence base that has been developed thus far. The present study’s aims of extending and applying more reliable and valid research designs to evaluate the intervention are then presented.
An ABA single case experimental design (SCED) was used to evaluate the effectiveness of the intervention in increasing, maintaining and generalising the social confidence and independence, as well as the sense of school belonging, of the participants. Weekly classroom based video observations, which were coded, using an adapted version of Thunberg, Ahlsen and Sandberg’s (2007) Communication Coding Scheme, explored the participant’s social confidence and independence development and maintenance. Pre, post and delayed measures using The Social Competence Inventory (Rydell, Hagekull & Bohlin, 1997) and The Belonging Scale (Goodenow, 1993) assessed the participant’s parent and teachers perceptions of skill generalisation and the participant’s self-reported sense of school belonging.
Outcomes from the SCED showed that the majority of the participants (five out of six) improved in at least one of the social communication skills measured and this maintained post intervention for three of the participants. An increase in perceptions of the participant’s social communication skills was reported within the school (five out of six) and home environment (three out of six). All participants rated a high level of sense of school belonging prior to the intervention, and change was variable per participant following the intervention.
Study limitations require acknowledgement when considering the outcomes, particularly the generalisability of the findings due to the design of the study and stability of some of the participant’s Baseline phases that reduce the reliability of the measures. The study concludes with some support for the positive impact Lego® Therapy can have on social confidence and independence. Recommendations are made for future research to enhance the growing evidence base for this intervention.
In 2008, Bellini and Peters conducted a review of empirically based social skills training procedures for youth with autism spectrum disorders. The results of this review suggested that targeted intervention using social skills training programs that were intensive and implemented in a child's natural setting were best suited to meet the needs of children with autism spectrum disorders. In the current article, a review of the most recent meta-analyses is included. Detailed investigation regarding the effectiveness of 8 social skills training procedures is updated and reviewed. Finally, a discussion of assessment strategies is included.
Copyright © 2015 Elsevier Inc. All rights reserved.
In this study, we investigated the psychological effects of an activity for collaborative expression using LEGO ® blocks. In particular, we focused on the issues of social skills and trust in 39 high school students. Each participant was asked to answer questionnaires concerning social skills and trust before and after the activity. The results showed that, although trust in oneself did not increase significantly, both social skills and trust in others increased considerably with the help of the activity.
This paper focuses on scoping studies, an approach to reviewing the literature which to date has received little attention in the research methods literature. We distinguish between different types of scoping studies and indicate where these stand in relation to full systematic reviews. We outline a framework for conducting a scoping study based on our recent experiences of reviewing the literature on services for carers for people with mental health problems. Where appropriate, our approach to scoping the field is contrasted with the procedures followed in systematic reviews. We emphasize how including a consultation exercise in this sort of study may enhance the results, making them more useful to policy makers, practitioners and service users. Finally, we consider the advantages and limitations of the approach and suggest that a wider debate is called for about the role of the scoping study in relation to other types of literature reviews.
Gifted students with Asperger syndrome (AS) frequently exhibit behaviors that puzzle and challenge teachers and other professionals. They display many of the behaviors typically associated with AS and therefore receive educational interventions designed to address their deficit areas. Often lacking is strength-based programming--that is, educational planning with systematic attention to students' learning strengths, interests, gifts, and talents. If their strengths are not addressed, these students are at social, emotional, and academic risk. Gifted students with AS require dually differentiated instruction, including interventions that foster interests and strengths while providing strategies to compensate for areas of weakness. This article offers suggestions and resources for developing strength-based programming for gifted students with Asperger syndrome. (Contains 2 figures and 3 tables.)
Deficits in joint attention (JA) and joint engagement (JE) represent a core problem in young children with autism as these affect language and social development. Studies of parent-mediated and specialist-mediated JA-intervention suggest that such intervention may be effective. However, there is little knowledge about the success of the intervention when done in preschools.
Assess the effects of a preschool-based JA-intervention.
61 children (48 males) with autistic disorder (29-60 months) were randomized to either 8 weeks of JA-intervention, in addition to their preschool programs (n = 34), or to preschool programs only (n = 27). The intervention was done by preschool teachers with weekly supervision by trained counselors from Child and Adolescent Mental Health Clinics (CAMHC). Changes in JA and JE were measured by blinded independent testers using Early Social Communication Scale (ESCS) and video taped preschool teacher-child and mother-child play at baseline and post-intervention.
Clinicaltrials.gov: NCT00378157.
Intention-to-treat analysis showed significant difference between the intervention and the control group, with the intervention group yielding more JA initiation during interaction with the preschool teachers. The effect generalized to significantly longer duration of JE with the mothers.
This is the first randomized study to show positive and generalized effects of preschool-based JA-intervention.
This paper presents a best evidence synthesis of interventions to increase social behavior for individuals with autism. Sixty-six studies published in peer-reviewed journals between 2001 and July 2008 with 513 participants were included. The results are presented by the age of the individual receiving intervention and by delivery agent of intervention. The findings suggest there is much empirical evidence supporting many different treatments for the social deficits of individuals with autism. Using the criteria of evidence-based practice proposed by Reichow et al. (Journal of Autism and Developmental Disorders, 38:1311-1318, 2008), social skills groups and video modeling have accumulated the evidence necessary for the classifications of established EBP and promising EBP, respectively. Recommendations for practice and areas of future research are provided.
This study examined the effectiveness of a social skills training program for normal-IQ adolescents with autism. Five boys participated in the 4 1/2-month treatment condition; four boys matched on age, IQ, and severity of autism constituted the no-treatment control group. In addition to teaching specific interactional and conversational skills, the training program provided explicit and systematic instruction in the underlying social-cognitive principles necessary to infer the mental states of others (i.e., theory of mind). Pre- and post-intervention assessment demonstrated meaningful change in the treatment group's performance on several false belief tasks, but no improvement in the control sample. No changes, however, were demonstrated on general parent and teacher ratings of social competence for either group.
To conduct a systematic review of rigorously evaluated school-based interventions to decrease bullying.
MEDLINE, PsycINFO, EMBASE, Educational Resources Information Center, Cochrane Collaboration, the Physical Education Index, and Sociology: A SAGE Full-Text Collection were searched for the terms bullying and bully.
We found 2090 article citations and reviewed the references of relevant articles. Two reviewers critically evaluated 56 articles and found 26 studies that met the inclusion criteria.
The types of interventions could be categorized as curriculum (10 studies), multidisciplinary or "whole-school" interventions (10 studies), social skills groups (4 studies), mentoring (1 study), and social worker support (1 study).
Data were extracted regarding direct outcome measures of bullying (bullying, victimization, aggressive behavior, and school responses to violence) and outcomes indirectly related to bullying (school achievement, perceived school safety, self-esteem, and knowledge or attitudes toward bullying).
Only 4 of the 10 curriculum studies showed decreased bullying, but 3 of those 4 also showed no improvement in some populations. Of the 10 studies evaluating the whole-school approach, 7 revealed decreased bullying, with younger children having fewer positive effects. Three of the social skills training studies showed no clear bullying reduction. The mentoring study found decreased bullying for mentored children. The study of increased school social workers found decreased bullying, truancy, theft, and drug use.
Many school-based interventions directly reduce bullying, with better results for interventions that involve multiple disciplines. Curricular changes less often affect bullying behaviors. Outcomes indirectly related to bullying are not consistently improved by these interventions.
Social support for families
- A Albanese
- San Miguel
- S Koegel
Albanese A, San Miguel S, Koegel R. Social support for families. In: Koegel RL,
Koegel LK, eds. Teaching Children with Autism: Strategies for Initiating Positive
Interactions and Improving Learning Opportunities. Baltimore, MD: Brookes
Publishing; 1995:95e104.
Gifted students with Asperger syndrome
- M Bianco
- D Carothers
- L Smiley
Bianco M, Carothers D, Smiley L. Gifted students with Asperger syndrome.
Intervention Sch Clin. 2009;44(4):206e215.
Considering individual variation in triadic interaction among children with autistic features during a technologyenhanced LEGO ® building activity
- K Tuonen
- S Kiskinen
Tuonen K, Kiskinen S, K€ arn€ a E. Considering individual variation in triadic
interaction among children with autistic features during a technologyenhanced LEGO ® building activity. In: Viteli J, Leikomaa M, eds. Proceedings
of Education Media Conference. Tampere: Association for the Advancement of
Computing in Education; 2014:1466e1475. Tampere, Finland, 23-26 June
2014.
An exploration of a communitybased LEGO ® social-skills program for youth with autism spectrum disorder
- J Mccormack
- I Matheson
- N Hutchinson
McCormack J, Matheson I, Hutchinson N. An exploration of a communitybased LEGO ® social-skills program for youth with autism spectrum disorder.
Except Educ Int. 2015;25(3):13e32.
Therapy: Developing Social Competence in Children with Asperger Syndrome through Collaborative Lego Play
- Brett E Lego
Brett E. Lego Therapy: Developing Social Competence in Children with Asperger
Syndrome through Collaborative Lego Play. PhD Thesis. UK: University of Exeter;
2013.
Effects of a Lego ® Intervention on Social Skills in Kindergarten Children with Autism Spectrum Disorders
- M Yalamanchili
Yalamanchili M. Effects of a Lego ® Intervention on Social Skills in Kindergarten
Children with Autism Spectrum Disorders. PsyD Thesis. US: Philadelphia College
of Osteopathic Medicine; 2015.
A case study in autism intervention: a novel conversational approach
- J Andrews
- J Francois
- K Coufal
Andrews J, Francois J, Coufal K. A case study in autism intervention: a novel
conversational approach. In: Proceedings of the 8 th Annual Symposium on
Graduate Research and Scholarly Projects, Wichita, US, 18 April 2012. 2012:
56e57.
Play and Imagination in Children with Autism
- P Wolfberg
Wolfberg P. Play and Imagination in Children with Autism. New York, NY:
Teachers College Press; 1999.