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audio infrastructure for assistive software?

I've been making significant progress on getting audio output to work from Perkify
(my attempt at a blind-friendly VM, based on Ubuntu, Vagrant, and Virtualbox) to
macOS.  The plan is to have it work with Linux and Windows hosts, as well.  The
current setup only uses ALSA and PulseAudio, but I'm planning to add JACK to the
mix <g>, by means of the pulseaudio-module-jack package.

I've installed a number of audio-related accessibility packages, including BRLTTY,
Fenrir, Orca, etc.  I'd also like to support Emacspeak, the vOICE, and others.  So,
I'd like to know if there are any common themes in how these sorts of packages use
audio output.  For example, do they generally tend to use ALSA and PulseAudio?

Feel free to contact me off-list or on the Perkify mailing list (perkify.groups.io)
if your response seems to be veering too far off-topic for this group.  I'm also
interested in finding folks who would like to help by testing and/or configuring
these sorts of packages.


P.S.  For more information on Perkify, visit its Introduction page:

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