Sociality in Autism: Building Social Bridges in Autism Spectrum Conditions through LEGO® Based Therapy

Abstract

Background: Autism Spectrum Conditions are associated with difficulties in core social communication and social interaction (American Psychiatric Association, 2013) and comorbid psychopathology (Simonoff, Pickles, Charman, Chandler, Loucas & Baird, 2008). These problems are often exacerbated in middle childhood and adolescence owing to the increased complex social milieu for children on the spectrum. The present study aimed to evaluate the effectiveness of a short-term LEGO®-based therapy for children and adolescents with high functioning Autism Spectrum Conditions. Another interesting and novel aspect of this study is the application of repertory grid technique (Kelly, 1955) to explore psychological changes in construing over the course of the LEGO®-based therapy. Methods: Twenty-five high functioning children and adolescents with Autism Spectrum Conditions (M =12.40, SD = 2.02) took part in an eight-week, clinic based LEGO®-based therapy sessions within an outpatient, mental health setting. Baseline, pre- and post-intervention outcome measures, including parent- and self-reports and repertory grid technique, were administered to assess changes during the eight-week baseline period with that during the eight-week intervention period in the area of autism specific social behaviours, adaptive functioning, psychopathology, and construing. Results: On average, participants made significant gains across autism specific social behaviours, adaptive social and maladaptive behaviour, psychopathology, and coping following LEGO®-based therapy but not during the baseline period. In addition, participants also showed some changes in construing, including the way they viewed themselves and person with ASC, a loosening of construing and an overall change in construing from pre- to post- intervention. Effect sizes (Pearson’s r) for these statistical significant results ranged from medium to large. Correlations between construing and psychopathology were also noted but not for autism-specific social behaviours or adaptive functioning. Conclusions: Overall, LEGO®-based therapy was a highly attended group (M = 89.5%) and well received by participants and their parents. These findings suggest that LEGO®-based therapy is feasible, cost-effective and can be set up in mental health services as part of the treatment plan for children and adolescents with high functioning Autism Spectrum Conditions. Future studies should focus on the effectiveness of LEGO®-based therapy with girls on the spectrum or children with social related conditions and conduct large scale randomised controlled trials.