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Marie
McCullough, The Philadelphia Inquirer, April 08, 2008
The Lego raft carrying the Lego castaways approached the Lego
island, ''chased by raptors.''
Lewis Roberts, a 12-year-old from Medford, N.J., moved the raft
an inch, then another young filmmaker snapped a digital camera.
A third boy consulted their script.
''Quiet on the set!'' In the sudden silence, the boys let out a
raptor-like ''ROAR.''
Lego animation is like a cartoon. The illusion of movement is
created with a sequence of slightly different photographs of the
colorful plastic brick construction sets.
But this wasn't just fun and games. It was ''Dr. Dan's
Lego-based Social Development Therapy'' — one of the many
interventions that have been developed to teach social skills to
children with autism.
The eight preadolescent boys who gathered one evening recently
in the playroom at the Center for Neurological and
Neurodevelopmental Health in Voorhees, N.J., have been diagnosed
with some form of the mysterious malady.
Their weekly hour together under the watchful guidance of three
trained adult leaders helps them learn to interact and
communicate socially — crucial abilities that are, by
definition, impaired by the neurological disorder.
''They're willing to be social creatures — as long as they can
get this Lego thing built,'' said the aptly named Daniel ''Dr.
Dan'' Legoff, the center's pediatric neuropsychologist.
At first glance, the $45 session just looked like a bunch of
boys having fun, not surprising since Lego Club members have
good language skills and average or above-average intelligence.
In contrast, children at the severe end of the autism spectrum
may be mute and have catatonic behaviors.
But signs of problems were soon evident. A boy wearing a
long-sleeve T-shirt stood amid the hubbub, staring at the floor,
obsessively pulling the hem of his shirt — until leader Greg
Shugar gently drew him into an activity. At a table, Lily Brown,
another leader, helped two boys revise their ''script'' — a
sheet of lined paper covered with angry scratch-outs and
scribbles.
Jonathan Shanahan, 13, of Riverton, N.J., rocked from foot to
foot and acknowledged that earlier that day, in school, he threw
a pencil at a classmate.
''He's my archrival,'' Jonathan declared, holding a winged Lego
beast he had created.
Early intervention
Autism is a heartbreaking puzzle. The cause is unknown, although
theories abound and genetics seem to play a role. The incidence
of autism has increased dramatically over the last few decades,
yet no one knows whether this reflects greater awareness and
improved diagnosis, or environmental changes, or both.
The encouraging thing, said Mark Mintz, president and founder of
the center where the boys were gathered, is that early
intervention usually helps: ''You can change the developmental
biology.''
The surest way of doing that is unclear. Countless approaches,
techniques and medications — not to mention alternative
therapies, special diets and vitamin injections — are available.
Few have been subjected to rigorous studies of effectiveness.
In Legoff's opinion, too many popular strategies involve ''skillstreaming''
— systematically explaining, modeling and role-playing
acceptable social skills to children.
''I found that approach to be, first, boring and painful to go
through for the kids. And second, it didn't seem to work,'' said
the psychologist, who has treated children with neurological
disabilities for 20 years. ''I needed to find something that
they could practice but that they would enjoy and be motivated
to do.''
About 15 years ago, during post-doctoral training in Honolulu,
Legoff noticed that his autistic patients, most of them boys,
ignored a playroom full of toys — except for Legos.
How Lego Club started
A hallmark of autism is an obsessive dedication to one or two
interests or activities — typically involving taxonomies,
mechanical systems, hierarchies.
''A couple kids came with Lego creations they made at home,''
Legoff recalled. ''In the waiting room, these kids started
talking to one another, which surprised their parents. These are
kids that don't have any friends because they're socially
rejected or isolated.''
Thus was born the Lego Club.
To force communication and collaboration, Legoff assigned
rotating roles. The ''engineer's'' design had to be acceptable
to the ''builder,'' who had to get parts from the ''supplier.''
Jonathan's year-old group, one of eight at the center in
Voorhees, has reached the club's premier level — ''master
builder'' — so now members devote their sessions to producing
stop-action videos. These are shown at the Lego Club's annual
''film festival,'' attended by adoring fans (relatives).
''I feel bringing Lewis here has brought him out of himself,''
said Karen Roberts, mother of one of the filmmakers. ''He's
loved Legos since he was a tiny kid. But before this, he didn't
really socialize a lot.''
Lynda Shanahan, Jonathan's mother, said: ''I wouldn't say he has
dramatically changed since coming here. The diagnosis is like
layers: Peel away one problem and another comes up. But I have
seen growth. This has helped him get a group of friends where he
fits in. It's built his self-esteem.''
Legoff — who says he's tried and utterly failed to get freebies
from the Lego company — has made modest efforts to popularize
his therapy. He has published two studies of its effectiveness
in medical journals. He has given presentations to several
school districts.
And he has done collaborative research on the methodology with
Simon Baron-Cohen, a distinguished psychologist at Cambridge
University's Autism Research Centre in England.
In a small study submitted for journal publication, Baron-Cohen
and colleagues found Lego therapy more effective than a
better-known social skills intervention at reducing autistic
behavior. It also was better at improving social interaction on
the playground, apart from the therapy group.
''If these findings remain positive (in larger studies), then
these approaches could be used in schools and clinic settings to
make them widely accessible,'' the study concluded.
Why it hasn't caught on
Yet Lego therapy hasn't really caught on, for several reasons.
It's more difficult and expensive to do than it may look. It's
not suitable for severely autistic children. And it's not based
on any particular theory of what is wrong in the autistic brain.
''Because it evolved a-theoretically, it doesn't fit a
particular theoretical framework. A lot of professionals don't
like that,'' Legoff said.
Even Bancroft Neurohealth, a Haddonfield, N.J., treatment
organization where Legoff used to work, no longer offers Lego
therapy, said Matthew Sharp, principal of Bancroft Elementary
and Preschool.
But Sharp tells families about it and refers them to the
Voorhees center.
''I think it allows socialization in a unique way,'' Sharp said.
''And when a child has a birthday, now he has friends to invite
back to the house, or to a movie night. So all these cool things
can emerge from this group.''
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