Assessment Forms

Matching Person & Technology Guide to Forms

Assessment Process and Instruments

The MPT instruments take a personalized approach to assessing the potential technology need; choosing the most appropriate technology given the user’s goals and preferences, the technology features, and environmental support.

Features

§ Provides a general technology screening and evaluation as well as specific technology matching.

§ Instruments are applicable across individuals, categories of disability, types of technology, and environments of use.

§ Based on underlying MPT model with multiple research studies testing the model with different populations and technology use situations

§ Specific instruments can be completed in approximately 15 minutes; a more comprehensive battery can be completed in approximately 45 minutes.

Note: The forms are designed so you can easily complete them on your computer. Use the Tab key (or Arrow Keys) to move forward from field to field. Use Shift/Tab (Left Arrow or Up Arrow keys) to move backward in the fields. You can also print the forms and complete them by hand.

Downloads

Download the entire collection:

View the list below to preview or download each form individually

Download zip file of new 2019 version of forms (individual PDFs + manual) [7.276mb]

(You may need to click the blue "Download" button after clicking this link)
Old versions:Download zip file of Microsoft Word Doc forms (fillable on a computer) [283kb]Download zip file of PDF forms for printing [1mb]Download zip file of RTF forms for printing [218kb]Download PDF of the MPT Manual including all forms [3mb]


To view forms individually, click the links in the list below (Steps in the MPT Process). All downloads will open in a new tab. Type CTRL+SHIFT+TAB to cycle through tabs without clicking.

Steps in the MPT Process


Step One: Use Form 1: Initial Worksheet for the Matching Person and Technology (MPT) Model, to determine initial goals and potential interventions supportive of goal achievement.

Step Two: Use Form 2: History of Support Use, to identify supports used in the past, satisfaction with those supports, and those which are desired and needed but not yet available to the consumer.

Step Three: Specific technology matching. The consumer and professional complete the version of the appropriate form depending on the type of technology under consideration.



Step Four: The consumer and professional discuss factors that may indicate problems with optimal use of the technology.

Step Five: After problem areas have been noted, the professional and consumer work to identify specific intervention strategies.

Step Six: The professional and consumer work to devise and document an action plan to address the problems.

Step Seven: A follow-up assessment is conducted to determine any adjustments or accommodations needed to the technology and to inquire into goal achievement and whether the consumer has changed priorities. For Assistive Technologies, specific follow-up forms have been developed that can be used to correlate initial and follow-up information and assess AT outcomes. Theses forms are:

Form 4-1: Assistive Technology Device Predisposition Assessment - Consumer (Follow-Up)

Form 4-2: Assistive Technology Device Predisposition Assessment - Professional (Follow-up)

Readministering Form 4-R: Recommendations

For the other types of technologies being matched with a consumer (general, educational, workplace) administering the same forms pre and post technology will provide an idea of changes in the consumer perspectives of that device or product.


Checklist for Service Providers

Checklist of Various Influences on a User's Suboptimal AT Experience

(Click here to download, or view below)

MATCHING PERSON_postcard front_rev.pdf

Additional Information

For additional information about the Matching Person and Technology Process review the other materials on this website. You can also contact the Institute for Matching Person and Technology directly.

Next: Workbooks