Screen reader users will want to uncomment the GRUB-TUNE line in /etc/default/grub and then run grub-mkconfig -o /boot/grub/grub.cfg if for no other reason they get an indication their computer is willing to boot before the screen reader comes on. A friend has a system without a pc speaker so pcspkr can't be used on it. We found putting an aplay command inside of /etc/rc.local pointing at a sound file got him that sound before his screen reader came up and a bonus in that since the sound played over the sound card he knew that the sound card would work and his screen reading goes out over that sound card. If a problem happens with the sound card he'll know before his screen reader comes up and has a chance to correct it.
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