A lot of good suggestions here already, but in terms of screenreaders, JAWS has a majority stake in the market. They make a tool call JAWS Inspect which gives

A lot of good suggestions here already, but in terms of screenreaders, JAWS has a majority stake in the market. They make a tool call JAWS Inspect which gives you reports (and by extension, version control) over your screenreader presentation. It's not free though.