Window-eyes comes with 4 dectalk choices.
dectalk-window-eyes, which is using your sound card and free,
dectalk access32 which uses your sound card and costs $75 but can be
used with any program that talks through your sound card. Well any
adaptive program that is.
Dectalk Express, which needs a com port. Dectalk USB which explains
what it needs by the name.