Instead of custom, homebrew speech packs one could leverage text-to-speech engines on existing platforms. Doing so is probably no small amount of work, but it'd vastly improve the accessibility of non-speech games.

Thanks for the quick reply. I didn't realize ScummVM had isolated engine code. Though, I don't think the problem is insurmountable. Creating such an abstraction to work with the most widely used engine would be my first step. Unfortunately my day job leaves my hands too tired to get into the source ...

Are steam copies of games like FOA still unsupported? They don't seem to work with 1.6.0. Anyone know where in the source this prohibition exists?

It's possible to control the mouse with things like VoiceFinger or Windows Speech Recognition macros. Though, my experience is that doing so is quite slow. "A New Beginning" does have a very helpful keyboard shortcut to show all hotspots (space bar). When used with WSR or VF it's possible ...

Some older games had text-based interfaces. Would it be possible to use speech recognition with newer games too? Perhaps as a ScummVM add-on or feature?

Are there any speech recognition or standardized keyboard inputs/shortcuts for ScummVM or the supported games?