NVDA is pretty responsive. If you're having trouble with it, the problem 
is probably the SAPI Anna voice. I find that Microsoft SAPI voices are 
sluggish and laggy.

You can go into NVDA settings, then into Preferences, then into 
Synthesizer to use eSpeak. You can also go to the NVDA site to find 
other voices, and if you're a fan of Eloquence, you can Google a string 
like "Eloquence, NVDA," to find an unofficial version of the TTS for 
that screen reader.


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