The Assistive Technology Assessment Process: Four Steps to the Right Device
Getting the right piece of assistive technology is not a shopping decision — it is an assessment process. The distinction matters. Shopping starts with products. Assessment starts with the person, their goals, and the contexts where they live. Federici and Scherer's Assistive Technology Assessment (ATA) model, developed through international clinical and research collaboration, organizes this process into four clear steps. Families and users who understand these steps are far better equipped to navigate the system.
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Step 1: Access — getting to the right team
The process begins with access: reaching the professionals who can properly evaluate needs and options. In many countries this means a referral to a center for technical aid, a rehabilitation clinic, or a specialized outpatient service. The quality of access varies enormously — it depends on geography, insurance, national health policy, and whether the user knows what to ask for. Barriers at this stage explain why many people who would benefit from assistive technology never receive a proper evaluation. Advocating for a referral, and knowing what kind of specialist to ask for, is often the first real task.
Step 2: Selection — matching the solution to the person
Selection is the heart of the assessment. A multidisciplinary team — which may include an occupational therapist, a rehabilitation engineer, a psychologist, a speech-language pathologist, and a social worker — evaluates the individual's functioning across motor, sensory, cognitive, and psychosocial dimensions. They also assess the environments where the device will be used: home, school, work, community. The goal is to identify the assistive solution — which may involve one device or a combination of several — that best matches what the person can do, what they want to do, and where they need to do it.
Step 3: Delivery — handing over the device with training
A device handed over without training is a device on its way to the closet. Delivery in the ATA model includes fitting and configuration, practical training for the user and caregivers, and written reference materials. It also involves making sure the home or school environment is prepared to receive the device — that doorways are wide enough, that charging cables have a home, that other people in the household understand basic operation. This step is routinely underfunded and underestimated, and it accounts for a large share of the abandonment problem.
Step 4: Follow-up — reassessing on a schedule
The ATA process does not end at delivery. A follow-up evaluation — typically at one month, three months, and six months — confirms whether the device is actually being used, whether it is achieving the intended functional outcomes, and whether anything needs to be adjusted. Bodies change, contexts change, goals evolve, and devices wear out. Follow-up is the safety net that catches mismatches before they become permanent abandonments. In the research literature, the presence or absence of structured follow-up is one of the strongest predictors of long-term device success.
Why the process beats the transaction
The four-step model is user-driven at every stage: the selection is based on the person's well-being and goals, not on what is in stock or what the clinician is most familiar with. It is also grounded in the WHO's International Classification of Functioning, treating disability as the product of an interaction between the person and their environment, not as a fixed property of the body.
Key takeaways
Access, selection, delivery, and follow-up — those are the four steps of a proper assistive technology assessment. Families who receive all four steps consistently get better outcomes. Those who receive only one or two — usually just the device, with neither rigorous selection nor follow-up — are the ones who end up with equipment in the closet.
When families enter the rehabilitation and assistive technology system, they often carry a purely medical framing of disability: diagnosis causes impairment, impairment causes limitation, and the goal is to fix or compensate for the impairment. That framing shapes what questions get asked, what interventions get tried, and what counts as success. But it is not how contemporary rehabilitation science actually understands disability — and understanding the difference leads to better decisions.
Assistive technology is any tool, device, or piece of software that helps someone do a task they would otherwise struggle with. The category is enormous — from a three-dollar jar opener to a twenty-thousand-dollar powered wheelchair — and that breadth is exactly what makes it confusing. The clearest way to think about assistive technology is not by product category but by daily routine. Walk through a typical day, find the moments that are harder than they should be, and you will find the right tools quickly.
