Tommy MacKay was principal investigator for the ‘Microsegmentation Study’, a major research project funded through Scottish Autism by the Scottish Government to take forward the recommendations of the Scottish Strategy for Autism.

The overall aim of the study was to identify the escapable costs of autism, that is, those which would not be incurred with early and appropriate interventions, and to provide the evidence base on which these can be applied to the context of the population of Scotland.

By ‘microsegmentation’ we aimed to identify those features of ASD that have a functional impact on individuals and an economic impact upon society. Every individual with autism is unique. However, people with similar features, such as severe learning difficulties, or high levels of challenging behaviour, are likely to have many similar needs and to benefit from a similar range of interventions or services.

The study had three main strands. First, we carried out a meta-analysis of prevalence of ASD which we have applied to the Scottish context. Any economic analysis of the costs of autism in society is dependent on prevalence – the question of ‘how many’ – and that is a question which, despite a vast worldwide literature, required a much more robust answer than it had been given.

Second, for the same reason we carried out a meta-analysis of autism and intellectual ability. The question of whether someone with ASD also has a learning disability is again of crucial importance since, in general, that points to the need for a higher tariff of service provision on a lifelong basis. However, estimates of the distribution of learning disabilities within ASD were extremely variable and unreliable.

Third, we carried out a major survey of the issues faced by a large sample of people with ASD in Scotland and of the services used by them and required by them.

On the basis of all evidence gathered, an economic analysis of the costs of autism in Scotland and of how that relates to different segments of the ASD population has been prepared, as a basis for informing priorities for intervention and service provision.

The research team was as follows:

In Glasgow, at the University of Strathclyde: Professor Tommy MacKay, Professor Jim Boyle and Michael Connolly.

In London, at London School of Economics: Professor Martin Knapp, Valentina Iemmi  and Amritpal Rehill.

An overview of the aims, rationale and structure of the microsegmentation study was provided in a special issue of Good Autism Practice in 2013. The study was published by the Scottish Government in March 2018, and the full report, The Microsegmentation of the Autism Spectrum, is available.