No nonsense accessibility 2
What we can do
Web standards have been established by the w3c and though browser manufacturers consistently fail to implement these standards, they remain a good test as to how pages conform, having a degree of accessibility built in. Furthermore there are tools available (w3c validator, webAim) and Firefox even offers accessibility plug-ins. Css is supposed to be more screen reader friendly but it’s still a black art how to compose a basic table using just css.
However these tools are only half the story, usability being the overriding consideration: Disability covers a large area of impairment and often we are only talking about visual impairment, or more specifically how the screen reader accesses the pages. This really has to be seen in operation for the web designer to appreciate how a visual impaired user, sees their pages: As a general rule of thumb, if a web page looks like a manuscript then the screen reader/user will have little problem navigating that page. However if the screen resembles an advertising hoarding with lots of complex imagery, tables & linking (usually flash) then this makes life more difficult for the visually impaired to navigate.
While tools form a first level check, direct feedback from VI users is invaluable.
Skimming
The main thing to appreciate is that the screen reader being a serial device, there is an intrinsic disadvantage in the way a VI user can access a page. Sighted users frequently skim pages, alighting on passages of interest. This becomes very difficult for the screen leader unless text is paragraphed and logically titled. Then there is the whole pdf situation which though improved, is still problematic.