While browsing in a thrift store one day, Kathleen Jordan came across a huge garbage bag of Lego pieces. Then in her late sixties, the Louisville, KY, native had no interest in the toys for herself but thought they would be nice for her son and granddaughter to play with when they visited. Little did she know how much that large bag of Legos would affect her life.

Diagnosed with multiple sclerosis (MS) more than 10 years earlier, Jordan had battled cognitive dysfunction, or brain fog, a common and sometimes debilitating symptom of MS, as well as stress, fatigue, and an inability to focus. Back home from the thrift shop, Jordan began sorting the bricks of Lego by color, just to pass the time. But gradually, as she got more creative and started assembling figures and constructing scenes, she noticed her brain fog beginning to lift.

She also felt like she had more attention and sharper focus and was significantly more relaxed. "I started figuring out problems more quickly," says Jordan, now 70. "For example, instead of taking a shopping cart loaded with groceries over to where I had parked my car, I would drive my car around the back of the building and unload the cart there—common-sense things like that."

But the most surprising change was how confident she felt. "I realized I could build things with dimension, and that was a big aha moment for me," she says. "It was like, if I can do this, I can do anything."

Jordan had unknowingly stumbled across something that psychologists have used for years with patients: Lego therapy. Pioneered in 2003 by Daniel LeGoff, PhD, a clinical and developmental pediatric neuropsychologist, Lego therapy has been used in group settings to help people with autism, attention deficit hyperactivity disorder (ADHD), and anxiety improve their social interaction.

One of the earliest Lego studies, conducted by Dr. LeGoff and then published in the Journal of Autism and Developmental Disorders in 2004, noted that children with autism were more likely to interact with other children after completing Lego therapy. They also were less aloof and rigid when interacting with others. According to a three-year retrospective study on the long-term effects of Lego therapy, published in Autism in 2006, children who had done Lego therapy showed significant improvements in social interaction compared with the control group. More recently, a 2017 review of Lego therapy studies published in Disability and Health Journal found that autistic children who participated in the therapy had an easier time interacting with peers, showed greater coping skills, and spent less time playing alone.

In a typical 90-minute group session, a supervisor divides participants into groups of three and gives each person a role: the builder, who assembles the set; the parts supplier, who provides the materials to the builder; and the engineer, who relays instructions to the other two. The teammates need to work together to build their set successfully, explains G.W. Krauss, PsyD, an operational psychologist for the US Army at the JFK Special Warfare Center and School in Fort Bragg, NC. In Lego therapy sessions Dr. Krauss conducted when he was assistant director at Y.A.L.E. Schools (for young people with special needs) in Cherry Hill, NJ, he noticed marked progress in students' social contact after just a few weeks.

Dr. Krauss says that informal parent-led Lego clubs would benefit children on the autism spectrum, but without a licensed or certified professional it wouldn't be considered therapy. "Working with children who have autism, including supervising Lego therapy, requires a considerable amount of expertise," he says.

Multiple Benefits

With Lego therapy, children learn to take turns, follow directions, and stay focused without much assistance from the therapists, both in the group and outside of it. "Playing with Lego allows kids to be creative, but they also have to follow a set of rules, which is especially good for autistic kids," Dr. Krauss says.

It works for a wide variety of personalities, he adds. "Even kids who don't have a natural interest in Lego or no social competence can easily be brought into this world, because they can build anything," he says. "If a child is really interested in weather, we can build a weather station. If we have a kid who's into trains, we build a train."

Research on Lego therapy has mostly focused on autism, but that's starting to change. In 2018, Kathleen Jordan approached Norton Neuroscience Institute in Louisville to share how playing with Lego had helped ease her MS symptoms. Intrigued, the institute designed a small pilot study to test the therapy's effectiveness.

"We recruited a group of 10 patients with MS and asked what they hoped to get out of this type of therapy," says Geeta A. Ganesh, MD, MPH, a neurologist at Norton Neuroscience. "They told us they wanted to improve their fine motor skills and their ability to multitask and interact with others." The patients then participated in a weekly Lego club supervised by Amber Brennan, an occupational therapist, and overseen by Dr. Ganesh. Researchers collected patients' self-reported data about their symptoms and abilities at the start of the club and again 10 weeks later. Patients were also asked to put together small sets every day at home.

The results were encouraging, says Dr. Ganesh, although researchers aren't sure whether it was the Lego therapy itself or the socialization that helped patients. Regardless, at the end of the 10-week period, patients reported a significant decrease in fatigue, an increased sense of belonging, and higher confidence overall. In addition, "patients reported that many of their [fine motor] skills improved, from buttoning clothes and manipulating items to writing," says Dr. Ganesh. Even participants who needed help assembling pieces at the start were able to work independently by the end, says Brennan.

Because the study was observational and outcomes self-reported, the results were not designed to be statistically significant, Dr. Ganesh says. But the research team is using what they've learned to explore whether Lego therapy can help patients with other conditions. A second group will include patients with Parkinson's, essential tremor, and stroke. The team also is seeking funding for future studies. In the meantime, the institute continues to host a weekly club for anyone who wants to participate.

Debbie Epperson, a patient in the pilot program who was diagnosed with MS in 2007, says she's "addicted" to the sense of accomplishment she gets from working with Legos. In addition to the weekly club at Norton Neuroscience, Epperson orders her own kits—an Easter bunny, a chick—and builds in her spare time. Between the club and completing Lego sets on her own, Epperson has seen her focus sharpen and her irritability recede. "I just can't say enough about it," Epperson says. "It's good, affordable therapy."

Devin Garlit would agree. The Delaware native, who was diagnosed with MS in 2014, started using Legos after he heard about it at his rehabilitation facility. "With MS, I experience several cognitive and physical problems, like short-term memory loss, trouble concentrating, weakness, and difficulty controlling my hands," he says. "My team suggested building with Legos to work my mind and hands and improve the connection between them."

Garlit was skeptical, but over time he saw improvements in muscle control and focus. "At first I could barely put a small set together. I was very slow," he recalls. "Now I can do much more complex sets, which seemed impossible when I first started." Building with Legos also helps him deal with the stress of his diagnosis. "I get a lot of nerve pain, and one of my coping strategies is to work on a project and just lose myself in it," he says.