Built-in USB works well with Mac OS X Sierra. (You need to install FTDI drivers which are not included in Arduino IDE). There were problems with Mac OS X and another LilyPad with a separate USB board. I recommend using this one instead (as does AMX3d customer support). I've had some technical issues with previous purchases of the same board, but the amazing AMX3d customer service team was committed to fixing it. One of the best customer service experiences I've had in a while.
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