Use host system accessibility APIs?
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brennanyoung commented
Rather than copying a subset of the behaviour of screen readers, would it not be better to hook into the host system accessibility APIs? (i.e. those already built-in to Windows, MacOS, Android, iOS, Linux). Those APIs are fairly mature and stable. Moreover they are predictable for assistive tech users.
Relying on host system accessibility APIs, you can support a much wider range of assistive technologies, including custom user dictionaries, preferred voice synthesisers, switch interfaces, braille interfaces or whatever.