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Basically it just reads out what's displayed on the screen.
The speed is configurable by the client, and at top speed it is indeed very fast. You know the reaction you get from a non-mudder when they look at your screen and see all that text flying past? The way they can't understand how anyone could possibly keep up with that much information? Well my initial reaction to the screen readers was like that.
But apparently you can get used to it, just as a sighted player can can get used to picking out the useful information at a glance. You can even skip to the end of a sentence, which is useful when you know what it's going to say.
Still, there are ways to make it easier for the blind player. A way to switch off the prompt can make a big difference. The ability to set aliases to show important information, so they don't have to go through the spam of the entire 'score' screen every time they want to check their hp. Things such as colour and table layouts are pretty useless for them, so providing more screen reader friendly ways of accessing that sort of information can also be a big help.
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