It is a busy Friday morning at Harston and Newton Primary school, in a village just south of Cambridge, and three excited five and six‑year‑olds are playing with Lego. But this is no Lego-bucket free-for-all, this is a carefully choreographed attempt to build a lorry.
Five-year-old Kaillum is studying a set of instructions intently and guiding his two classmates. "You need four white pieces with four bumps and two red see-through bits with one bump," he tells six-year-old Harry.
"You're not allowed to look at the instructions, dude" he adds, as Harry leans over to see for himself.
This is definitely not playtime. This is Lego therapy in action.
Each child has their own job: engineer, supplier or builder. The engineer has the instructions, which must not be shown to the others (hence Kaillum's hard line). The supplier has the pieces, and the builder must put the toy together. The engineer must tell the supplier which pieces to give to the builder and describe to the builder how to put it together without showing them the pictures.
Lego therapy was originally developed in the US by Dr Daniel LeGoff, a paediatric neuropsychologist, in around 1999. It was discovered by accident when two of Dr LeGoff's clients – both eight-year-old boys with Asperger's syndrome, who struggled with social interaction – were found playing excitedly and talking together in the waiting room. This was completely out of character, as previously the boys had shown no interest in either each other or anybody else. But by complete coincidence, both boys had brought Lego creations to their appointments that day and as one was arriving and the other was leaving, they had discovered that they both shared a passion for Lego.
Dr LeGoff set up special sessions to allow the two boys to meet and play Lego. This allowed therapists to work with them on improving their social skills. The boys were happy to work together, share, take turns and resolve any conflicts, just so long as they were allowed to build Lego models. Other youngsters visiting Dr LeGoff's clinic expressed an interest in joining the Lego Club sessions and soon seven children were taking part.
An evaluation of Lego Clubs found that taking part in weekly hour-long sessions of Lego therapy led to "significant" and "sustained" improvement in participants' social skills and a decline in "repetitive, stereotyped behaviours". Research comparing it with other interventions concluded that children receiving Lego therapy demonstrated "significantly" more improvement than those in the other group.
The format of the sessions – with engineer, supplier and builder – was designed to force children with social difficulties to work together and use complex language to make themselves understood.
The idea was brought to Britain by Gina Gomez-de-la-Cuesta, then a prospective PhD student working with Professor Simon Baron-Cohen at Cambridge University's Autism Research Centre. She went to the US, was trained in Lego therapy by Dr Le Goff, and returned to the UK where she set up Lego Clubs. "It has been a cascade effect," Dr Gomez-de-la-Cuesta says. "I have been up to Inverness to train people and they have cascaded it throughout the Highlands and down to Brighton. Lego Clubs are happening all over but they tend to happen in clusters, as people find out about it by word of mouth.
"We must be careful not to overegg it. We are not saying this is the next cure for autism but there have now been three or four studies that show encouraging results. In terms of evidence, it is still quite small but it is a small-but-promising evidence base."
Dr Gomez-de-la-Cuesta is co-author of a new book, Lego-Based Therapy: How to Build Social Competence Through Lego-Based Clubs for Children with Autism and Related Conditions, which she hopes will help people to set up more clubs.
"Lego is very appealing to children," she says. "There is not a stigma attached to going to Lego Club, whereas there might be to going to a social-skills club. Children with autism are often not motivated to learn social skills, but by using Lego we can get them to communicate in a fun and naturalistic way.
"You deal with social difficulties as they arise at the club. It's quite a skill for the facilitator of the group to help the children work through any problems they face. It's important they learn the skills in a naturalistic way – not by rote."
So far, research into the clubs has only focused on children on the autistic spectrum but Dr Gomez-de-la Cuesta believes the therapy could be applied to a much wider range of difficulties, including social and emotional problems and nonverbal learning disorders.
The Lego Club was introduced at Harston and Newton Primary as part of a research project set up by Dr Ellie Brett, an educational psychologist in Cambridgeshire who was investigating the use of Lego Clubs in schools (previous studies having only examined the impact of clubs in health clinics). Dr Brett helped set up Lego Clubs in 13 Cambridgeshire primary schools in 2013 as part of her study, which was particularly interested in children's views of the clubs. She says: "The premise was that because children are interested in Lego, they will be motivated to take part in the clubs."
In fact, Brett discovered that – while the children enjoyed the clubs and wanted to attend more often – some also found the social dynamics difficult and were often frustrated with other group members, whom they invariably thought were not as good at Lego building as they were. On the other hand, the earlier clubs in health clinics were usually exclusively for autistic children, while the Cambridgeshire schools used them for mixed groups of pupils. (Although some had been diagnosed with autism and others had social difficulties, some children were chosen to attend simply to improve their confidence and improve the balance of the group.)
Whatever the differences, Lisa Murphy, the headteacher at Harston and Newton School since 2006, is delighted with the club's success. She says: "We were looking to support our children who needed help with social skills and that included those who had been identified as having Asperger's when Ellie approached us. We thought it might be useful but it has fulfilled our expectations many times over. I think the proof of its success of it is the fact that we are still running it three years on.
"The simplicity of it was surprising and I think it is that simplicity which has allowed us to see really strong outcomes. We see children who have been part of the programme reverting to some of the techniques that they have learned at Lego Club – taking turns, joining in activities – and they have been able to generalise these skills into other activities. There are more and more schools in Cambridgeshire using Lego Clubs now because heads talk when they get together and the message has got around about how helpful it has been."
At another school, Houghton Primary, in a village further north in the county, mixed groups of children – including pupils diagnosed as being on the autistic spectrum – are using Lego to improve their social skills. Charlie, Lola and Cameron, all aged eight, agree that they love Lego Club. "It helps us make new friends," Lola says. "And it helps us learn about sharing, talking and listening," says Jo Taggart, the special needs-support worker who runs the clubs. Georgina Young, the headteacher, adds: "This has been very important for developing their social skills and improving their ability to relate to each other."
Taggart believes that children are more likely to apply skills that they have learned in Lego Club to other everyday life situations, whereas techniques taught in social-skills lessons tend not to be used elsewhere. "Often you teach kids about eye contact, for example, in social skills but they don't generalise it. But when they do it in Lego Club you then see them doing it elsewhere."
Not that the clubs are all plain sailing. As mentioned above, Brett's research revealed that many children found others difficult to interact with and said they would have preferred to play alone. They told Dr Brett about arguments they had had with other group members in the past and complained that other children were "so annoying" or always "being an idiot".
Still, says Dr Brett, that's all part of learning to socialise: "Collaborative play is fundamental to Lego therapy as it is the avenue within which appropriate social interaction is taught, facilitated and practised. Working through disagreements within sessions enables appropriate social skills to be learnt."
Not that the children even realise. As Cameron says: "I like Lego Club because you get to make things out of Lego!"
'Lego-Based Therapy: How to Build Social Competence Through Lego-based Clubs for Children with Autism and Related Conditions' by Daniel LeGoff, Gina Gomez-de-la-Cuesta, G W Krauss and Simon Baron Cohen is published by Jessica Kingsley PublishersReuse content