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Investigating SOcial Competence and Isolation in children with Autism taking part in LEGO-based therapy clubs In School Environments (I-SOCIALISE): study protocol


Introduction Social skills training interventions for children with autism spectrum disorder (ASD) typically focus on a skills deficit model rather than building on existing skills or encouraging the child to seek their own solutions. LEGO-based therapy is a child-oriented intervention to help improve social interactional skills and reduce isolation. The therapy is designed for school-age children with ASD and uses group-based play in a school setting to encourage peer relationships and social learning. Despite the reported potential benefits of LEGO-based therapy in a prior randomised controlled trial (RCT) and its adoption by many schools, the evidence to support its effectiveness on the social and emotional well-being of children with ASD is limited and includes no assessment of cost-effectiveness.

Methods and analysis This multicentre, pragmatic, cluster RCT will randomise 240 participants (aged 7–15 years) with a clinical diagnosis of ASD to receive usual care or LEGO-based therapy with usual care. Cluster randomisation will be conducted on a school level, randomising each school as opposed to each individual child within a school. All prospective participants will be screened for eligibility before assenting to the study (with parents giving informed consent on behalf of their child). All participants will be followed up at 20 and 52 weeks after randomisation to assess for social, emotional and behavioural changes. The primary outcome measure is the social skills subscale of the Social Skills Improvement System completed by a teacher or teaching assistant associated with participating children at the 20-week follow-up time point.

Ethics and dissemination Ethics approval has been obtained via the University of York Research Ethics Committee. The results of the trial will be submitted for publication in a peer-reviewed journal and will be disseminated to participating families, education practitioners and the third sector including voluntary and community organisations.

Trial registration number ISRCTN64852382; Pre-results.

  • paediatrics
  • mental health
  • autism spectrum disorder
  • public health

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  • Contributors DV, BDW, CC, DM, KB, SG, GGdlC, ALC, AM and MDT were responsible for the conception and design of the draft of the protocol. EK, TC, NS and EC were responsible for substantial alterations to the protocol and design of the study and the acquisition of the data. SA was responsible for the design and analysis of the health economic component of the trial. All authors made substantial contributions to the drafting, critical revision and final approval of the document.

  • Funding This work is supported by the NIHR’s PHR funding stream (grant number PHR 15/49/32).

  • Competing interests The research team are aware that the LEGO name is a registered trademark and will follow their fair use policy in regard to the LEGO brand throughout the duration of the trial. Co-applicant Gina Gomez de la Cuesta coauthored the LEGO-based therapy manual 17 which will form the basis of the LEGO-based therapy delivered in the trial. The coauthors of the manual have given us full permission to use the manual without licence and to develop an abridged version. They have also stated their support for us in writing our own version, and will become coauthors on any future publications. Co-applicant Gomez has also agreed for the team to adapt the fidelity checklist used in her previous study. We have provisional agreement with Jessica Kingsley Publishers who have expressed interest in publishing the abridged manual. However, we are not tied to them as a publisher. There are no other financial and/or competing interests to declare.

  • Ethics approval Ethical approval was granted by the University of York’s Department of Health Sciences on 17 March 2017 (HSRGC/2017/205B) and HRA approval was given on 30 June 2017.

  • Provenance and peer review Not commissioned; peer reviewed for ethical and funding approval prior to submission.

  • Patient consent for publication Not required.

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