Posted by sylvia on Monday, August 03, 2009 (17:52:17)
OCRegister By MARIE MCCULLOUGH
VOORHEES, N.J. 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.
Early intervention helps
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.
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.”
Birth of a club
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.
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.”
Newport Beach clinical child psychologist Kristen Iverson uses Legos to work on communication and social skills with her patients with autism. For younger children who need to learn conversational skills, she plays a game that uses Legos as cues for asking questions and sticking with a topic.
“I think it’s interesting to use something that motivates them as a way to get them to engage in things that are less motivating, which is learning new social skills,” she said. “It results in them having a good time at the same time as they’re learning new skills.”
Getting results
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.
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.”
From http://www.autisticsociety.org/News/article/sid=1116.html