Several guidelines to follow:

Structure – Simple screen readers scan text left to right and top to bottom; making your document hierarchical and linear can ensure the text you include makes sense to someone using a screen reader.

Typeface – The typeface you use in your document can aid readers with visual impairments. Use standard fonts, particularly fonts without serifs (sans serif) to help designate the form a letter.

Conveying emphasis – Proper punctuation can help you convey emphasis in the text if you know how it is interpreted. Screen readers provide a brief pause at commas and a longer pause at periods. You may want to include periods at the end of section headers to convey the start of a new section. Screen readers generally don’t read hyphens and parentheses so you may want to use commas in lieu of other punctuation marks.

Templates and Formatting – Some screen readers are quite advanced and make use of Word templates. Using a template and the formatting options already built into Word can make your work easier and more accessible for your audience.