From some of my earlier investigations, handicapped computing support is astonishingly bad and expensive. Largely because many things are near one-off limited-use solutions that can't be re-sold... but nothing is ever modular or adjustable or could be tweaked to be used in multiple situations anyway. The DIY crowd for such things, meanwhile, keeps hacking up things like this for almost no money.

And it only gets worse once you come to software. Hardware interfaces have a general communication format - websites do not. Applications do not. Almost nobody makes software with hinting for assistive devices, despite tools and standards existing. I suspect it's mostly because it's extra work, and doesn't (usually) significantly help to pay the bills when added.