**4. Collaborative block creation for ASD adolescents**

This section will provide examples of the clinical applications of collaborative block creation based on evidence mentioned in previous sections of this chapter. While this method is useful with several clinical subpopulations and ages, we specifically focused on the application of this approach for groups of adolescents with developmental disorders, particularly ASD.

As LeGoff [15] demonstrated, toy blocks are very attractive to children and act as useful materials in the evaluation of children with developmental disorders. His "LEGO® therapy" method is well structured and effective as a social skills training program for them. However, the "block technique" approach in this study allows for more freedom in expression than other approaches; furthermore, it can be applied in a group therapy setting for children with developmental disorders. We tested the collaborative creation approach with a group of ASD children. We created small groups of three to five children that met with one of the facilitators. Based on Kato et al. [28] study, the effect of the group is reviewed in this section.

### **4.1. Participants**

Six Japanese adolescents with ASD joined the study. Three were junior high school students, and the others were high school students. All participants were male, diagnosed based on DSM, and categorized in the high-functioning ASD.

#### **4.2. Procedure**

In contrast, we could not find significant differences in the sense of authenticity, perceived acceptance, and relief. However, the sense of role concerns with social skills, the other factors are more individual factors, and they might relate with the personality of each participant. Therefore, it is considered that they did not change in short time. It is important to examine the effect of the continuous collaborative activity over a longer period of time in future

General sense of Ibasho 4.04 0.69 4.15 0.73 \* Sense of authenticity 4.29 0.83 4.23 0.91 Sense of role 3.49 0.90 3.87 0.86 \*\* Sense of perceived acceptance 4.04 0.89 4.11 0.91 Sense of relief 4.60 0.48 4.55 0.45

**Before After**

**Mean SD Mean SD**

We examined the effect of collaborative block creation on the sense of Ibasho in this study.

**4. Collaborative block creation for ASD adolescents**

The result showed that the collaborative activity increased the general sense of Ibasho and sense of role especially. The findings indicated that the activity can be a useful medium for communication in group therapy or social skills training program. However, this finding is meaningful for future clinical application, and we need to interpret the result of the study carefully because the result is based on the limited setting of healthy samples. The study that includes the view point of both genders, generation, and clinical samples are necessary in the

This section will provide examples of the clinical applications of collaborative block creation based on evidence mentioned in previous sections of this chapter. While this method is useful with several clinical subpopulations and ages, we specifically focused on the application of this approach for groups of adolescents with developmental disorders,

As LeGoff [15] demonstrated, toy blocks are very attractive to children and act as useful materials in the evaluation of children with developmental disorders. His "LEGO® therapy"

studies.

\* p < .10. \*\*p < .01.

future.

particularly ASD.

**3.5. Conclusion**

**Table 2.** Scores of Ibasho before and after a collaborative task.

42 Socialization - A Multidimensional Perspective

The study was conducted in a social skills training group for ASD students. The group contain six times program, and it includes several social skills training activities. The collaborative block creation was held in the second time of the group. Participants were divided into two groups. One group consisted of the junior high school students and the other of the high school students. As shown in the previous section, the participants were asked to express themselves collaboratively with the other group members and encouraged to build anything they wanted on the group's plate using LEGO® blocks and figures. Graduate students majoring in clinical psychology joined each group as facilitators. The creation was completed within 1 hour. Participants responded on the trust scale [19]. This scale originally included three subscales: "trust for oneself," "trust for others," and "distrust." We used "trust for oneself" (six items) and "trust for others" (eight items) in this study. After the entire process was finished, group members presented their works to each other and shared their experience.

#### **4.3. Results and discussion**

The scores of each item of the trust scale were compared before and after the group work. The scores from after the work were categorized into three groups as "increased," "decreased," and "not changed." The percentages of these three groups were compared to "trust for oneself" and "trust for others." The results showed that there were significant differences both in "trust for oneself" (χ<sup>2</sup> (2) = 13.50, p < .01) and "trust for others" (χ<sup>2</sup> (2) = 19.63, p < .01). Multiple comparisons showed that "not changed" was larger than "decreased" (p < .05) in "trust for oneself." In addition, "increased" and "not changed" were larger than "decreased" (p < .05) in "trust for others."

The total number of participants who increased and decreased the scores of the items in the trust scale was counted. As a result, the score increased in the majority of the participants regarding the items "I am worthy of trust" and "I can trust myself" on the subscale "trust for oneself." In addition, there was an increase in "I can keep trust with others if we face problems" and "I trust others based on my experience." There were no decreasing items for the majority of the participants.

However, the increased scores did not rise significantly; the category of "not changed" was higher than "decreased" in "trust for oneself." This means that the collaborative block creation does not have negative effects in regard to their trust for themselves. Participants presented their image on the base plate, and the facilitator watched the process. This secure framework of the block technique contributed to the result. The scores were particularly increased in the items "I am worthy of trust" and "I can trust myself." These items directly represent selftrust in simple words more than other items, and the increase here might reflect participants' experience of the collaborative work. The previous research has shown that ASD students have low self-esteem or distrust because of continuous experiences that show them that they are unable to establish relationships smoothly with others. The collaborative block creation is useful in assisting with secondary issues such as low self-esteem and distrust.

they can use their talents effectively at universities. However, many ASD students are not good at smoothly establishing relationships with others. Such difficulties sometimes cause maladaptation to the university, and this problem is aggravated after the students drop out. Individual student counseling deals with the problem, and until recently it was the only way to help ASD students. Recently, attention has begun to focus on therapy involving a group approach for students with developmental disorders. This section will introduce a case of a new group approach for university students, based on the work of Kato and Yura [29].

Improving Social Skills through Collaborative Artwork and Group Activity

http://dx.doi.org/10.5772/intechopen.74789

45

In regard to student counseling, when many students with ASD attend counseling, their main problem is relationships with others. However, while individual counseling can reduce their daily stress, preventive approaches are also necessary. This case study attempted some group approaches from this perspective. One of the groups in the study was named "Collector's Club." Any student from the university could join the group, both students with ASD and students with no such diagnosis. The group was announced by poster and website at the university. In some cases, a counselor would refer students to the group. Such collaboration between individual counseling and the group is important. The main aim of this group was to support improving the social skills of participants through their collections or hobbies. While ASD students have interesting collections and hobbies, it is not always easy for them to find friends with whom to share these interests while at the university. The group was planned in order to provide an opportunity for students to present their hobbies and a chance to make new friends. The group was held in a classroom at the university after class. Every session was approximately 90 minutes long and held once a month. A clinical psychologist and psychiatrist joined the group as facilitators. In each session, one participant took on the role of

This section summarizes one of the cases from the Collector's Club. The participant was a male university student with high-functioning ASD (diagnosed based on DSM), majoring in science. He had difficulty forming good relationships with laboratory members, and his professor referred him to the group. He participated in the group with a total of 15 times. He was nervous when he joined the group the first time. He said "Many people talking together looks like fun. However, it is difficult for me to join them; today's experience is exciting" (#2). He brought a book for the club, but he hesitated to show it to other members. The facilitator talked to him and asked about the book. Then, he gradually talked about it (#5). He brought a photo album for the other members. These were his favorite photos, which he collected using the Internet, and he introduced each photo to the other members (#7). He brought a leaflet of the event to the university and presented on it. It was impressive that he voluntarily checked out the event and was able to share his interests with others (#8). He began to talk to other members in a loud voice and said "I want to try things I'm not good at" (#11). He again brought some event leaflets. Other members took an interest in them, and they talked to him. While in the past he had only been able to communicate with other members if the

presenter and introduced his or her own hobby or collection.

**5.1. Details of the group**

**5.2. Case report**

In contrast, the category of "increased" was higher than "decreased" in "trust for others." This means the collaborative work increased students' trust for other group members. The previous section examined the effect of collaborative block creation on Japanese high school students and showed that the work increased feelings of safety and a sense of acceptance of others. Participants in the present study had the same experience, thus explaining the increased trust for other members. In particular, the scores were increased in the items "I can keep trust with others if we face problems" and "I trust others based on my experience." Collaborative creation facilitated participants' communication, and this positive process affected their trust for others. Therefore, blocks are familiar toys for participants and play the role of a medium for nonverbal communication.

The facilitators were responsible for implementing the collaborative creation approach. Although the participants tended to convey a very narrow range of expressions at the beginning, they gradually started to communicate and collaborate more with each other. This process proved effective in helping the participants increase their social skills, self-efficacy, and satisfaction. We are currently preparing to test this approach with a group that includes children with several different developmental disorders, such as ASD and ADHD. Although ASD children prefer to be alone and stay in their own world, ADHD children are often interested in many different things and actively communicate with others. The social differences between these two groups of children may represent a good opportunity for the participants to communicate with each other. Of course, the facilitators will have to closely monitor the group dynamics closely, maintain a good atmosphere, and secure the framework of the approach in order to effectively facilitate the communication.
