Brltty <http://dave.mielke.cc/brltty/> is a daemon which sends the Linux        
console to a refreshable braille display. Text-to-speech doesn't work for
everyone, and a braille display is better for Unix-type-things anyway. The
program seems to work well, it's not very large, and the author is very
responsive. Getting tools like this into a mainstream distribution is a huge win
for Linux. I'm preaching to the choir, here, I know. :)