Based on the experience garnered through a longitudinal ethnographic study, the authors reflect on the practice of designing and fabricating bespoke, accessible music tech- nologies. Of particular focus are the social, technical and environmental factors at play which make the provision of such technology a reality. The authors make suggestions of ways to achieve long-term, sustained use. Seemingly those involved in its design, fabrication and use could benefit from a concerted effort to share resources, knowledge and skill as a mobilised community of practitioners.