There is an interesting paper that is a set of observations on users who work with screen readers. Here are some of my notes:

1. Screen reader users scan with their ears. I saw a video of a blind person using the screen reader, and the speed at which they set the voice is really high. Sighted users will definitely have a hard time picking up even one word.
2. Screen reader users must remember a lot of information.
3. Most of the users do not use all the features of a screen reader
4. Screen reader users must somehow decipher mispronounced words (e.g. “VA” pronounced as “va”)
5. Most screen reader users do not use text-only versions. I also have noticed several sites have a “Text Version” of their site with stale content (sometimes even dated to 1999!).
6. Many users jump from link to link or use the list box
7. Many users miss the link to skip navigation. Label it as “Skip to main content” so that the readers accent is clear.
8. The find feature does not cycle through the entire page (i.e. it searches from where the pointer is to the last character but does not go back and search from the first character) and the cursor moves as it speaks.
9. Some screen reader users jump from heading to heading.
10. If screen-reader users are in form-filling (Edit) mode, they do not hear any text that is not part of a field.
11. Screen reader users find it difficult to find the form.
12. When filling out a field makes the page refresh, the software starts reading from the top as if it were a new page.