Building Bridges, Scenarios, Worlds of Possibilities - The Use of Lego as A Therapeutic Resource with Autistic Children

René Schubert*

*Correspondence to: René Schubert, Psychologist. Clinical Psychology and Neuropsychology, São Paulo, SP, Brazil.

Copyright

© 2024 René Schubert., This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: 22 February 2024

Published: 01 March 2024

DOI: https://doi.org/10.5281/zenodo.10848022

I bring up this subject because I regularly use Lego in my consulting room, mainly in child psychodiagnosis and play therapy. The people who have shown me this over the years have mainly been patients with autism spectrum disorder. Something about Lego always attracted them more than other toys: the colours, the shapes, the possibility of organising, segmenting, systematising - and then moving on to something deeper and more therapeutic: building scenes, creating characters, relating characters, naming emotions and beliefs.

As a psychotherapist who works with children, I have a toy room inside my consulting room with various games and toys. I use Lego, Playmobil, various dolls, sets, graphic and craft materials, board and card games, books, magazines, in short, play materials that arouse children's interest and that stimulate and allow the manifestation of fantasy, affective and bodily expression, and creativity.  I consider Lego to be a fantastic playful representative of human adult reality. It's a powerful ally in helping children make the transition from the world and imagination/fantasy of childhood to the world and reality of adulthood - or to understand and express them. Learning, through play, rules and limits, both for themselves and for others. Developing logical reasoning, creativity, abstraction, among others, through playful language.

Lego has many qualities and possibilities in its favour as a toy. By joining together multicoloured geometric pieces, you can build a pot, a wall, a car, an aeroplane, a tower, an entire city, a scene of struggle and domination, a scene of abuse, a happy, fun scene, a scene of meeting and reconciliation, romance or adventure... it all depends on the availability of this material in the consulting room, the attitude of the psychotherapy professional, the child's trust in the space for expression, the will, the goal, the skills and creativity with this toy.

In my opinion, several aspects count in favour of this toy: the aesthetics and shape it has and can take; the colourfulness of its pieces; the infinite possibilities for construction, joining and creation; characters with various facial and body expressions; construction of 3D scenes; various characters from the world of children, games, cinema, comics and books; the personification of fantasy; the use of creativity and logic; patience and tolerance of frustration; co-operation and exchange; expression and communication; playful elaboration; construction and deconstruction; meaning, re-signification and emotional discharge; skills that develop in contact with toys and by the playing.

I can see the importance of play and this toy in various clinical situations in the consulting room but, as many professionals have expressed in a series of studies and research, Lego can be very specific in the care of children on the autistic spectrum. And indeed, this toy is proving to be a differential in establishing bonds and exchanges with children with this clinical condition. Here I'll give some examples of these theories and their possibilities in the clinical psychology context.

Some of the history of the LEGO toy

Created by Danish carpenter Ole Kirk Christiansen in 1934, Leg Godt, known worldwide as Lego, means "to play well". Born as a small workshop, the company was responsible for manufacturing handmade wooden toys.

Lego is a toy whose original concept is based on a patented system of plastic pieces that fit together, allowing for countless combinations. It is assembled by hand, without the use of glue. Considered an educational toy, it develops imagination, creativity, motor coordination, logical reasoning, spatial thinking and notions of depth and three-dimensionality. It stimulates concentration, planning, organisation, perception and differentiation of shapes and colours. According to the company, Lego follows four basic principles: high quality, safety, creativity / imagination and fun.

More than simple a toy

In the field of mental health, Lego has been used by psychologists as a therapeutic resource in psychotherapeutic assessment and follow-up.

"Lego-based therapy" for children with autism emerged in the United States through the studies of neuropsychologist Daniel Legoff.  In the book published in 2018, the author observed the interest that most of his patients with autism showed in Lego, compared to other toys he had in his consulting room. He realised that this common interest led several patients to maintain voluntary interactions in the waiting room and between sessions, bringing a sense of exchange and belonging. Daniel Legoff found that the patients were able to work as a team with Lego and that this was a therapeutic opportunity to conduct interventions in the children's behaviour and communication.  Generally, children with autism have difficulties with bonding, social exchange and communication - but through methodical activities they enjoy building and organising things. Lego attracts children because of its characteristics as an organised, logical, objective puzzle toy with different shapes and colours. It encourages systematic assembly with pre-established rules. The neuropsychologist noticed that children with autism were able to work in groups using Lego games and that it was possible to systematise the way they interacted and exchanged, stimulating communication, creativity and conflict resolution. All the children worked together to solve various assembly challenges. The children were given tasks to carry out and responsibilities such as: engineer, supplier and builder. These roles were swapped and changed during the course of the challenges and games. In this way, the psychotherapist ended up acting as a facilitator, stimulating interaction, communication, assembly strategies and challenges. When inappropriate or conflictive behaviour arises, it is looked at from the context of play, playfulness and humour, looking for ways out, adaptations and possibilities to resolve it appropriately so that the assembly can continue. In general, the following are the proven benefits of Lego therapy with autistic children: the feeling of belonging, the sense of achievement and well-being when the task is solved; the development of the socio-motor, visual and emotional skills of those involved.

Another example, now in the adult world, is in business consultancy, where Lego has been used as a resource for managing people, teams and strategies in the labour market, under the name "Lego Serious Play". The aim is to get team members to create metaphors, reflections and narrate experiences using Lego pieces and elements. Participants carry out these tasks by telling stories and building three-dimensional scenarios with Lego pieces. Lego is used in this way as a "serious game", played playfully by adults. As explained by KRISTIANSEN and RASMUSSEN (2015), the participants know that they will be using their imagination - that is, their ability to form a mental image of something that does not yet exist - to anticipate things that have not yet happened. They are exploring a plausible and possible state or seeing current reality in a different, playful way, as well as understanding its complexity and uncertainty in different ways. Other perspectives. This allows participants to develop a critical sense and think outside the box. They engage in this game to learn, generate options and develop new understandings together, working, co-operating, elaborating and stimulating the flow of information, communication and problem-solving for real issues and situations.

Brief cases through playfulness

"Tico came to the clinic aged 4. He presented with echolalia, repetitive behaviour, aloofness and impatience. The school referred him because of attachment difficulties and, based on the play therapy assessment, the way he played, his delays in language and self-care, his intolerance of frustration, his shouting and crying, it became clear that he was suffering from an invasive condition. This was later confirmed by an assessment with a child psychiatrist. As a result of his frequent throwing of objects, the Duplo - Lego toy was introduced at every session. Tico was amused by the pieces shattering and being rebuilt by the psychotherapist. He named the red and yellow ones, his favourites. I suggested rockets. They would go up and at a certain point fall down and shatter. Laughter. I encouraged him to build the rockets. Initial distrust, fear. But, "CRACK", it was great fun to see them break. New elements emerged: houses, buildings, people, astronauts. After a few sessions, the rocket no longer fell, but flew over the city. The city had a name, things were given names. Over the course of months, Tico's vocabulary, patience and attention were extended and maintained. He built cities, created characters and sometimes destroyed everything - but we could name it, talk about it, repair it, rebuild everything again"

 "It's good to remember that play is in itself a therapy" said paediatrician and psychoanalyst Donald Woods Winnicott (1975), one of the representatives of child psychotherapy. He emphasised the importance of play for children's development, pointing to play as the child's language, showing how they are developing concepts of external reality, of the adult world. Through play, the child elaborates external reality, captured and experienced, which will then be externalised in their own way through fantasy, motor and emotional discharge in and through play.

"Yuli was referred by the neurologist with a diagnosis of Asperger's Syndrome. At the age of 6 he was a serious child whose hobby was memorising dictionary entries. He had difficulties at school and at home because of his mood swings, impulsiveness and aggressive behaviour. He soon became interested in Lego signs pointing to a pirate island. For months we built pirate islands and caravels. Without dolls. In moments of frustration, he would break what he had built. We'd start again. After the pirates was a medieval setting. Yuli bonded well with the therapeutic space and the universe of Lego pieces there. One day I asked what a meeting between pirates and medieval knights would be like? Dolls appeared, weapons, battalions... conflicts and wars. We were together selecting doll faces that indicated anger, sadness, despair, defiance, joy... and we started writing scripts before assembling the sets with dolls and Lego pieces. We talked about human history. Battles and affections...problems and politics...and how to deal with them. Today Yuli is studying computer engineering and plans to work in character modelling for games. We continue to plan and execute constructions, while talking about family, colleagues and everyday difficulties."

As quoted by Sigmund Freud (1908) "Every child, when playing, behaves like a literary creator, because he constructs for himself a world of his own, or, more"

"Ben was 11 when he arrived at the doctor's with a diagnosis of autistic spectrum disorder from the age of five. He was sombre, silent and withdrawn. He saw a ship from the Star Wars series on the table and immediately started telling me what he liked about the film. Would the psychotherapist have any other ships? We started building different ships. Sometimes Sith, sometimes Jedi. Light and shadow. He showed me an app in which he assembled Lego sets virtually. Before that, I'd never actually assembled them with pieces. He marvelled at the aesthetics and the possibility of taking the ships in his hands and making them fly, meeting one another... colliding... to rebuild them again.  When he left, the ships would be displayed in a place he had chosen in his office. The debate between good and evil was frequent between constructions, battles and articulations. Over the course of four years, we built 12 different ships from the Star Wars universe. He took some of them to school and showed them to his mates, who became receptive and started talking more to the quiet boy, who they now knew was a Star Wars fan."

"Play is a creative human activity in which imagination, fantasy and reality interact in the production of new possibilities for interpretation, expression and action by children, as well as new ways of building social relationships with other subjects, children and adults," said Lev Vygotsky (1987). Playful language facilitates communication, both with oneself and with others. In this way, play, playfulness, become one of the forms of communication in psychotherapy.

In this way, I see playing, assembling and building with the Lego toy as a connective and fun tool for both ludodiagnosis and ludotherapy (Play therapy), in individual and group consultations. As a psychotherapist, I always try to focus on my clients' potential and abilities. The focus is precisely on the child's potential, regardless of the diagnosis - this allows for the healthy, creative emergence of communicative, social and cognitive skills.

Article written by brasiliean psychologist René Schubert and published in the book: Um Amor Azul – Os desafios e o caminho para lidar com a pessoa autista. Coordenação de Neia Martins e Viviane Oliveira, Editora Conquista, São Paulo, November 2023

Bibliographical Reference

1.Freud, S. (1908) - O escritor e a fantasia. Obras completas. Companhia das Letras, Volume 8, São Paulo, 2015

2.Kristieansen, P. & Rasmussen R. - Construindo um negócio melhor com a utilização do método Lego Serious Play. DVS editora, São Paulo, 2015.

3.Legroff, D. B, Krauss, G. & Baron-Cohen, S. – Terapia Baseada em Lego – Como construir competência social por meio de clubes baseados em Lego para crianças com autismo e/ou condições relacionadas. IEAC, Goiânia, 2018

4.Packham, A. (2016) - Lego-Based Therapy: How Colourful Bricks Are Helping Kids With Autism Improve Their Social Skills. Disponível em:    Acesso em: 12 Jan.2022

5.Schubert, R. - Marcia, a marca pela angustia: a experiência em clínica psiquiátrica infantil permeada pelo Humor. Avances en Psicologia Clínica: Investigación y Práctica, Editorial Dykinson, Madrid, Espanha, 2020

6.Schubert, R. - Case study: Floating Harbor syndrome and / or Pellitier-Leisti syndrome. Journal of Medical and Research Neurology and Psychology, Volume 4, Issue 1, United Kingdom, Dezember 2021

7.Schubert, R - O brinquedo Lego como alternativa terapêutica no tratamento de crianças com espectro autista. Apresentado como conferencia no 6º Congresso Brasileiro de Psicologia: Ciência e Profissão em São Paulo, 13 novembro de 2022

8.Vygotsky, L. - A formação social da mente. Martins Fontes, São Paulo, 1987

9.Winnicott D. W. - O brincar e a realidade. Imago, Rio de Janeiro, 1975