Might it be possible to get the two to talk to each other? If so, the implications would be pretty far reaching!
I believe that Jason is doing this for his entombed 2 sequel. I recommended the use of the Tolk library and he's got it to work.
That has some pretty astounding implications (e.g. blind accessibility plugin), I'll drop him a line
Do you know if there is anything like it for other platforms? I.e. mac/iOS/Android?
Not to my knowledge. I know that there are other screen reader output libraries that are capable of output to screen readers from multiple platforms like accessible output 2, but that's implemented in python.
I am also trying to get Tolk to work with Unity, but am stuck at a point where it doesn't seem to like NVDA. Do you know anyone I could ask?
For the past year I worked on a plugin that recreates screen reader functionality for Unity UI. It works like VoiceOver and TalkBack, and uses the native VoiceOver speech for text-to-speech output. It's already supporting iOS and Android and I'm now focusing on making it work on Windows with the most common screen readers as well.
It just got approved by Unity last night: