What is META?

Management of Everyday Technology Assessment, META, is an observation based assessment aiming at identification of performance skills, and skill deficits in use of everyday technology in older adults with Mild Cognitive Impairment (MCI) or dementia, but also in older adults in general, and people with cognitive impairments due to for example brain injury.

META - Symbol picture
META - Photo: Swedish Association of Occupational Therapists

The assessment starts with an interview, where the interviewer and the client reaches an agreement on technological objects and services that are relevant to the client but also somewhat challenging. This interview is based on a hierarchy covering everyday technologies of different challenge, from easy to hard. Thereafter the assessment takes place through an observation of the client’s use of 3-4 of these somewhat challenging technologies, then followed by an interview to capture the person’s own view on his/her performance skills. The assessment hence is a combination of observation and interview.

The META assessment covers 4 different areas: A/ Assessment of observable performance skills when the technology is being used (11 items), B/ Assessment, based on observation and/or judgment, of how environmental characteristics influence the use of this technology (2 items), C/ Overall judgment of the person’s capacity to use this technology based on all available information (3 items), and D/  Safety and the person’s appreciation of how important the technology is.

META has so far been most used in research concerning older adults with mild cognitive impairment or dementia, and also adults with acquired brain injury, in comparison to those with no known cognitive impairments. Education days have also been arranged for clinical occupational therapists in Sweden.  In the future, our goal is that META could be used in clinical occupational therapy when there is reason to pay attention to clients' ability to use technology, as a base for interventions for individual clients and as a base for general adaptations of technology or when design and testing new technology.


The work to create META was initiated in 2006 by Louise Nygård in collaboration with clinical occupational therapists and research colleagues, and with particular support from Swedish Brainpower. The point of departure was the emerging new insights about specific difficulties related to technology use available at that time through our research. This new knowledge indicated that particular skills related to technology use are important when performing activities that require the use of technology. Hence, having methods for investigation of this particular aspect seemed important, and to enable this, an instrument was needed. META was consequently built on two earlier studies: in one study, we had investigated the use of 86 common everyday technologies (objects and services) in samples of older adults with dementia or MCI compared to older adults with no known cognitive impairment. These 86 technologies could thereby be arranged in a hierarchy from easiest to most difficult to use (Rosenberg, Nygård & Kottorp, 2009). In the other study, we had qualitatively explored difficulties and obstacles to everyday technology use in a sample of older adults with mild to moderate dementia who lived alone, and this resulted in a taxonomy of types of difficulties related to technology use (Nygård & Starkhammar, 2007). In the META, the hierarchy describing level of difficulty of technologies is used as a point of departure in the initial interview aiming at identification of 3-4 technological objects or services that are relevant but somewhat challenging to the individual. The taxonomy covering types of difficulties when using technology was converted into a set of items in META, to be assessed in specific situations when a person is using his/her technologies. The first version of META was evaluated by Camilla Malinowsky in her PhD-thesis (2011). Anders Kottorp had, and still has, a particularly important role in this work as the expert in instrument development.

What can META contribute with in clinical work?

  • META offers a systematic method for investigation of individuals’ as well as groups’ observed ability to use everyday technology, in the homes as well as in society. META can be a complement to assessments within the field of activity (ADL/IADL/social activities) but it does not replace these.
  • META also provides added information about how the requirements of the context and the person’s prerequisites influence his/her ability to use everyday technology.
  • META can also provide information regarding the person’s perception of his/her skills when handling everyday technology.
  • META is a standardized method that provides detailed information about performance skills and skill deficits in daily life among clients who often are independent and where subtle changes in daily life activities are difficult to detect.
  • META can contribute by identifying target areas for interventions; occupational therapy interventions as well as others.

How can I get access to META?

During 2020, the Swedish Occupational Therapy Association has taken over META; they publish the META material (Swedish as well as English versions) and administrate the education (in Swedish only).

Through the following link you can read more about META.

Through the following link you can read more about the META course (in Swedish).

When somebody wishes to use the META in research, an agreement is made between the researchers and KI/Camilla MalinowskyLouise Nygård ​​​​or Anders Kottorp in each particular case.

Other questions can be directed to Camilla Malinowsky.

Languages: META is available in Swedish and English. It is not allowed to translate META to other languages. The intellectual property belongs to Camilla MalinowskyLouise Nygård and Anders Kottorp, and any questions regarding translations must be directed to us.

META in research

META has its origin and home in the research group Cognitive ACcessibility and Technology Use when ageing in home and Society (CACTUS), at the Division of Occupational Therapy, NVS, Karolinska Institutet.


Fischl, C., Malinowsky, C., & Nilsson, I. (2021). Measurement of older adults’ performance in digital technology-mediated occupations and management of digital technology. British Journal of Occupational Therapy, 84(6).376-387. https://doi.org/10.1177/0308022620937971.

Bartels, S.L., Assander, S., Patomella, A.-H., Jamnadas-Khoda, J. & Malinowsky, C. (2020). Do you observe what I perceive? The relationship between two perspectives on the ability of people with cognitive impairments to use everyday technology. Ageing & Mental Health, 24 (8). 1295-1305. https://doi.org/10.1080/13607863.2019.1609902.

Ballmer, T., Helle, T., Kaptain., R. J., Malinowsky, C. & Kottorp, A. (2019). Test-retest and inter-rater reliability of the Danish version of the META for use with older adults with and without COPD. Scandinavian Journal of Occupational Therapy, 26(6): 463-474. https://doi.org/10.1080/11038128.2018.1476585.

Malinowsky, C & Fallahpour, M, Larsson Lund, M., Nygård, L. & Kottorp, A. (2018). Skill clusters of ability to manage everyday technology among people with and without cognitive impairment, dementia and acquired brain injury. Scandinavian Journal of Occupational Therapy, 25(2), 99-107. https://doi.org/10.1080/11038128.2017.1298665.

Larsson-Lund, M, Kottorp, A. & Malinowsky, C., (2017). Return work in people with acquired brain injury: Association with observed ability to use technology. Scandinavian Journal of Occupational Therapy, 24(4), 281-289. https://doi.org/10.1080/11038128.2016.1194466.

Kottorp A, Nygård L, Hedman A, Öhman A, Malinowsky C, Rosenberg L, Lindqvist E, & Ryd C (2016). Access to and use of everyday technology among older people: An occupational justice issue – but for whom? Journal of Occupational Science, 23(3), 382-388. https://doi.org/10.1080/14427591.2016.1151457.

Kassberg, A. C., Prellwitz, M, Malinowsky, C. & Larsson-Lund, M. (2016) Interventions aimed at improving the ability to use everyday technology in work after brain injury. Scandinavian Journal of Occupational Therapy, 23(2),147-57. https://doi.org/10.3109/11038128.2015.1122835.

Malinowsky, C., Kassberg, A. – C., Larsson-Lund, M. & Kottorp, A. (2016). The stability of the test-retest reliability of the measures in the Management of Everyday Technology Assessment (META) among persons with acquired brain injury. Disability & Rehabilitation, Assistive Technology, 11(5), 395-399. https://doi.org/10.3109/17483107.2014.968812.

Malinowsky, C. & Larsson Lund, M. (2014). The association between perceived and observed ability to use everyday technology in working age people with ABI. Scandinavian Journal of Occupational Therapy,21(6), 465-472. https://doi.org/10.3109/11038128.2014.919020.

Kassberg, A. C., Malinowsky, C., Jacobsson, L. & Larsson-Lund, M (2013). Ability to manage everyday technology after acquired brain injury. Brain Injury, 27 (13-14), 1583-38. https://doi.org/10.3109/ 02699052.2013.837196.

Malinowsky, C., Kottorp, A. & Nygård, L (2013).  Everyday technologies' levels of difficulty when used by older adults with and without cognitive impairment –Comparison of self-perceived versus observed difficulty estimates. Technology and Disability, 25 (3), 167-176. https://doi.org/10.3233/TAD-130380.

Patomella, A. – H., Kottorp, A. & Nygård, L. (2013). Design and Management Features of Everyday Technology That Challenge Older Adults. British Journal of Occupational Therapy 76(9), 390–398. https://doi.org/10.4276/030802213X13782044946229.

Malinowsky, C., Almkvist, O., Nygård, L. & Kottorp, A. (2012). Individual variability and environmental characteristics influence older adults’ abilities to manage everyday technology. International Psychogeriatrics, 24 (3), 484-495. https://doi.org/10.1017/S1041610211002092.

Patomella, A. – H., Kottorp, A., Malinowsky, C. & Nygård, L. (2011). Factors that impact the level of difficulty of everyday technology in a sample of older adults with and without cognitive impairment. Technology and Disability, 23 (4), 243-250. https://doi.org/10.3233/TAD-2011-0331.     

Malinowsky, C. (2011). Managing technology in everyday activities: A study of older adults with dementia, MCI, and no cognitive impairment. Doctoral dissertation.  Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy. https://openarchive.ki.se/xmlui/handle/10616/40706

Malinowsky, C., Almkvist, O., Kottorp, A. & Nygård, L. (2010). Ability to manage everyday technology: A comparison of persons with dementia or mild cognitive impairment and older adults without cognitive impairment.  Disability & Rehabilitation, Assistive Technology, 5 (6), 462-469. https://doi.org/10.3109/17483107.2010.496098.

Malinowsky, C., Nygård, L. & Kottorp, A. (2011). Psychometric evaluation of a new assessment of the ability to manage technology in everyday life.  Scandinavian Journal of Occupational Therapy, 18 (1), 26-35. https://doi.org/10.3109/11038120903420606.

Publikationer till grund för META

Rosenberg, L., Nygård, L. & Kottorp, A. (2009). Everyday Technology Usage (ETUQ) – evaluation of the psychometric properties of a new assessment of competence in technology use. Occupational Therapy Journal of Research, 29 (2), 52-62. CI: 11.

Nygård L, Starkhammar S. (2007). The use of everyday technology by people with dementia living alone. Aging and Mental Health, 11(2), 144-155. CI: 20. https://doi.org/10.1080/13607860600844168.

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