Dear Peter and Edward:
This addresses both your issues:
Reading by Paragraph:
In Word, control plus up arrow or down arrow jumps from paragraph to paragraph. 
 In the Word Set File, a WE file, there is a cursor key set to "read paragraph" 
after one of these keys is pressed.  This works pretty well, but I've found, 
particularly in large documents or while connected through Citrix, that 
switching the cursor key simply to "read line" is faster.  The first line is 
all you need to hear, most of the time to decide whether you want to read the 
remainder of the paragraph, and even if you do, the down arrow is a better way 
to read, particularly if you're just trying to focus on one point.

Book Marks
For Peter, who is reading a huge document that has been run through OCR, you 
won't have many options since the document will not have been styled.  There 
may, however, be patterns.  For instance, a chapter heading may be displayed as 
"Chapter:".  So, look for the colon too.  Then, insert a bookmark.  Highlight 
the desired text and then press Alt-I for the insert menu and then the letter 
"K" for BookMark.  Type in a name, and press Alt plus A.  You can quickly jump 
to this spot with either the Window-Eyes insert plus tab function or by 
pressing Alt-I plusk again, by arrowning to the book mark name, and pressing 
Alt plus G (go to).

Go to in Word:
Control plus G, followed by shift plus tab puts you in a list of word format 
features that you can jump to, e.g., tables, sections, pages, and so-on.  That 
may help.
Headings:
Before going to the trouble of cutting the document into separate chapters, 
have someone go through the documentt and format it a little.  Each Chapter 
should be a Heading 1.
Do this by getting the chapter heading on a line by itself (pressing ENTER will 
do that).  Then press control plus alt plus 1.
Do the same for the first level section down, but press control plus alt plus 2.
Do the same for the third level with control plus alt plus 3.
You can actually do a fourth level, but there is no direct hot key.  You'll 
either have to go into styles and apply heading level 4 or, in the alternative, 
label the heading as level 3 and then immediately follow with shift plus alt 
plus right arrow -- to demote level 3 to level 4.
Then, you can quickly go to one of the headings.
One way is to go to view in Word, Alt plus V.  Then arrow to outline view.
After that, press shift plus alt plus 1 to see only heading level 1.. Alt plus 
shift plus 2 lets you see both heading levels.  Go to where you want to be at 
the outline view and then switch views to be in the selected chapter and 
section.
I think I forgot.  Before labeling headings, highlight the whole document and 
press Alt plus B to put the default text style at "Body Text."
There are about a dozen other navigation tricks, but these are my favorites. 

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