To add to this. If you do need accessibility tools, I have only verified that this works if you install Windows on the poor thing. Make sure your screen reader starts with the OS, and start Steam with -gamepadui on startup. Then do a bunch of things Microsoft really wants you not to do so you can skip the super annoying login prompts (only do this if you know what you're doing since like... you know... you're kinda disabling your login prompt), and boom it's as close to a blind accessible Steam Deck as I can get for now.
A fun, happy little Mastodon/Hometown instance.