Matching Person and Technology: Why Psychosocial Fit Matters as Much as Function
Rehabilitation professionals have long known that selecting the technically correct device is not enough. Studies consistently show that approximately 30% of assistive devices are abandoned within the first year of use. The devices usually work. The problem is almost never the engineering. Marcia Scherer's Matching Person and Technology model — one of the most studied frameworks in the field — was built specifically to address the factors that functional assessments miss: the personal, motivational, and psychosocial ones.
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What the MPT model measures
The MPT model asks three categories of questions before a recommendation is made. First, what is the person's subjective experience of their disability — how do they feel about needing assistance, and how do they feel about this particular technology? Second, what are the person's own goals and priorities for the device, and how important is the target activity to their sense of self and daily life? Third, what psychosocial and environmental factors in this person's life might support or undermine successful device use — family attitudes, peer norms, cultural acceptance, prior experience with technology?
These questions are distinct from the functional assessment (can the person physically operate the device?) and the environmental assessment (will the device fit the space?). MPT adds the interior dimension: does this person want this device? Will they use it willingly, or only when someone is watching?
Why predisposition predicts outcomes
Scherer's research introduced the concept of predisposition to use assistive technology — a measure of how ready and willing a person is, before the device arrives, to integrate it into their life. People with high predisposition are more likely to practice, to ask for help when problems arise, to maintain the device, and to persevere through the learning curve. People with low predisposition, regardless of how good the functional match is, tend to use the device inconsistently, report lower satisfaction, and ultimately abandon it more often.
Measuring predisposition is not about screening people out. It is about identifying what additional support will be needed to make the match succeed. A person with low predisposition may benefit from peer mentoring, from a gradual introduction, or from a simpler device that requires less commitment early on.
The social and cultural layer
MPT explicitly acknowledges that technology acceptance is socially constructed. A powered wheelchair may feel empowering to one user and stigmatizing to another. A communication device that is celebrated in a school setting may feel isolating at a family dinner. The person's cultural background, family attitudes, and social networks all shape whether the device becomes part of a life or a source of shame. Assessments that ignore this layer are working with incomplete information.
How the MPT tools work in practice
The MPT assessment toolkit includes a series of instruments — the Assistive Technology Device Predisposition Assessment (ATD PA), the Survey of Technology Use (SOTU), and others — that can be administered in a clinic visit or home setting. They generate a profile of the person's readiness, priorities, and psychosocial context that supplements the functional evaluation. Clinicians use the combined profile to tailor recommendations and anticipate barriers before the device is delivered.
Key takeaways
A device that fits the body but not the person will be abandoned. Matching person and technology means assessing function, environment, and psychosocial readiness together. The 30% abandonment rate is not inevitable — it drops significantly when the person's own priorities, attitudes, and social context are part of the selection process from the start.
A well-run assistive technology service looks nothing like a showroom or a catalog. It looks like a conversation. Cook and Polgar describe four service-delivery principles that consistently separate programs that deliver lasting results from those that ship devices and hope for the best. Families who recognize these four principles in a clinician or supplier can trust they are in good hands. Families who do not see them should keep looking.
The assistive technology field divides devices along a spectrum from mainstream to commercially available assistive to custom-made, and separately along a scale from low technology to high technology. Knowing where a device sits on both axes helps families make smarter purchases, because the marketing pressure is almost always toward the most complex, most expensive option — and that is very often the wrong choice.
