Historically, one-on-one technical support has also been the province of the third-party access companies, though this has changed dramatically during the past several years as both Apple and Microsoft have begun offering telephone and email support for their accessibility products. They catch up when they can, but third-party screen readers remain in a constant race to see which one can be out of the gate first with new solutions to new problems.
The built-in solutions don't always play well with new software that relies on non-standard ways of doing things. On the other hand, there is also a lot to be said for third-party solutions, such as JAWS, Window-Eyes, and NVDA. Even Windows has its built-in (albeit limited) offering, Narrator.
There is a lot to be said for built-in screen access, such as is provided on iOS, Android, Chrome OS, and Mac OS X.
