Lucy Prosser, Speech and Language Therapist, St Anthony’s School Lego® based therapy USING LEGO® TO DEVELOP LANGUAGE AND SOCIAL INTERACTION SKILLS Lucy Prosser, Speech and Language Therapist, St Anthony’s School

Aims of workshop At the end of the workshop you will: Have a better understanding of the rationale and research behind LEGO - based therapy Know what a LEGO - based therapy session looks like Have ideas about how LEGO – based therapy can be adapted to different levels of ability Have had a go!

Activity one In groups of 3 build a model using the LEGO on your table. Did you manage to build a model? How did you decide what to build? Did you take on any roles – were some people more involved than others?

Introduction: history and rationale Dr Daniel B LeGoff (paediatric neuropsychologist) mid 1990s in USA Originally devised for children with Asperger’s syndrome and high functioning ASD Devised to develop interaction through Sharing Turn taking Making eye contact Following social rules Using greetings and names

Evidence base 3 outcome studies: LeGoff (2004) N=47, LeGoff and Sherman, 2006, N= 60, Cambridge Autism Research Centre (2008) N=31 Research focused on the impact of LEGO therapy on social interaction and autistic behaviours Results showed statistically significant and meaningful improvements over time and in comparison to other forms of intervention (including SULP).

Why does it work? ‘The best kind of therapy is when it’s so much fun that the child doesn’t know it’s happening. LEGO-based therapy fits that bill.’ Lynn Koegel LEGO is motivating (based on a clear system) and frequently a common interest. Involves sustained interaction by dividing tasks of set building (set roles), governed by rules and facilitated by an adult. Social bonding as a result of joint focus on a common goal

What is Lego-based therapy? Collaborative play therapy in which children work together to build Lego models. Children have different but interdependent roles which necessitate interaction.

Lego-based therapy roles Engineer Holds the plan and gives instructions – which pieces to find and where to put them Supplier Finds the LEGO pieces for the builder Builder Follows the engineer’s instructions to put the pieces together

What does the ‘therapist’ do? Introduces, explains and reviews rules Helps children establish roles Models in the role if needed Facilitates sharing of roles (when to swap) Coaches key social skills – sharing, turn taking, looking, seeking clarification and verbal and non-verbal communication Focuses on communication and not LEGO model Offers free play opportunity at the end of the session

What does the ‘therapist’ do? Point the problem out Facilitate children forming solutions Solutions then practised Remind children of strategies in the future Therapist would only need to intervene where there was a problem that the children were unable to resolve themselves

Lego Therapy Rules 1. Build things together 2. If you break it you have to fix it or ask for help to fix it 3. Use indoor voices – no yelling 4. Keep hands and feet to yourself 5. Use polite words 6. Be patient – wait until the other person has finished talking 7. Do not put LEGO bricks in your mouth

Activity Two Follow the LEGO-based therapy format in groups of 3 to build a model.

Further developments The premise of LEGO therapy and subsequent research has focused on aspects of social communication and ASD behaviours. Other environments have seen the value of this approach in developing a range of language and communication skills. Speech and language therapists have found it equally motivating for children without ASD and a useful tool to develop their spoken language, functional language and understanding of language.

Potential speech and language aims for LEGO-based therapy Development of joint attention Development of listening skills Development of receptive and expressive language, particularly the number of information carrying words able to process and use Concept development (shape, colour, size, number, position) Active listening skills of seeking clarification through questions Development of turn-taking Development of problem solving skills

Evidence base St Mary’s School, Bexhill: significant gains in expressive language which carried over to classroom setting increase in concept development development of joint attention with peer reduction of maladaptive behaviours within sessions increased social awareness

Variations and adaptations Complexity of models Number of roles, number of staff Lego rules Lego points Blank sheet of paper for orientation

Variations and adaptations Use of photos to support instructions Introduce colour, shape and size cue cards Freestyling Use of ipads to photograph and present stages of model Awards – LEGO helper, LEGO builder, LEGO creator, LEGO master, LEGO genius Props – hats/tabbards for roles, lanyards

Aims of workshop At the end of the workshop you will: Have a better understanding of the rationale and research behind Lego-based therapy Know what a LEGO - based therapy session looks like Have ideas about how LEGO – based therapy can be adapted to different levels of ability Have had a go!