I love the concept and story here. It's such a cool setup for a small collection of games. Accessibility wise I like how there are a lot of options, not just for blind players. The ability to tweak the sound pan and pitch for multiple sounds is a really cool touch that I think I've seen done only once before. Being able to stop and look around, when looking at any text box, is a nice way to provide audio description. The sounds all fit together and the music is a banger.
My only small suggestion is the first time you start the game, perhaps have a spoken message to tell people how to turn on the screen reader mode if you can't detect if someone has a screen reader running. The first time I saw this game the friend playing it didn't look at the keys listed on the page at first, which for the rest of the game wouldn't have been a problem if not for the small detail of no speech after starting it :)
He did go back and figure it out and also had a blast in the end, but that's why I think such an announcement is important.