Microsoft offer an API called Active Accessibility which defines a standard way for clients (for example screen readers such as JAWS) to communicate with regular applications (called servers) which might not provide their own accessibility features.
This is one possible way to address the accessability of SecondLife, by taking the existing viewer code and making it conform to the Active Accessibility API. The alternative, which I was toying with earlier today, is to modify the SLeek viewer* to add self-voicing using SAPI 5.1 through SpeechLib in .Net 2.0
* It seems inappropriate to call it a viewer when there's nothing much to view, and especially as we're intending to create a piece of software that allows the user to hear the game.
Apparently in order to use SpeechLib in .Net 2.0 the SAPI DLL might need to be converted with TlbImp thus,
C:\Program Files\Microsoft Visual Studio .NET 2003\SDK\v1.1\Bin\TlbImp.exe "C:\Program Files\Common Files\Microsoft Shared\Speech\sapi.dll" /out:Interop.SpeechLib.dll
This is some example C# code demonstrating voicing:
SpVoice objSpeech = new SpVoice();
SpeechSDK51.exe from SAPI 5.1
.Net Framework V3.5 Beta 2 and Redistributable
JAWS 8 demo