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Richard, this might be a useful topic for MUO. Here's Apple's how-to about Voice Over: http://support.apple.com/kb/HT2529?viewlocale=en_US
Googled this and found a PDF guide from Colordo State website. Good and Short guide.
http://docs.google.com/viewer?a=v&q=cache:ichhJiJCj8kJ:atrc.colostate.edu/Data/Sites/1/documents/Quickstarts/MAC_OS_Accessibility_Built-Ins_Quick_Start_Guide.pdf+accessibility+guide+Mac&hl=en&gl=us&pid=bl&srcid=ADGEEShu3nRWi_ETvhkRZCJ32XEQae5oa0ZnwYhI5UAU1Qrv2DGbHiVy0ZKZn3bERwOJT1FFStj_hvvHVs6cnG108hdrH1aD-69mC_LsaEiIQUC9OT4DiZCSHkuVYyy1V30xThzEwfNY&sig=AHIEtbQxqIF_MD7LMDwSrwN4MOzi30nYng