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Leopard Reference: Cocoa
Support for external assistive applications is built into Mac OS X. An assistive application interacts with an application to allow persons with disabilities to use it. For example, it can enable the visually impaired to perform actions through verbal commands corresponding to menu items and button labels. By using Cocoa programming interfaces and following simple guidelines, developers can make the user interface of their applications available to these external assistive applications.
A guided introduction for developers who want to make their applications accessible to all users.  
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NSSpeechSynthesizer Class Reference (HTML) (PDF)
Describes the Cocoa parser that converts text to speech.
 2009-01-06
NSAccessibility Protocol Reference (HTML) (PDF)
Describes the interface for receiving accessibility-related messages.
 2007-12-11
NSSpeechRecognizer Class Reference (HTML) (PDF)
Describes the Cocoa command-and-control voice recognition system.
 2007-04-03