[General Questions and Answers] lopestom:
hello Coside76

I have a person I know with the same necessity as you and who uses Google services to use the device.

You have a few options besides the Google Talkback and Speech option. But it depends on your choice and usability.

Let's get to the point where if your device has Google services installed: Have you tried to install the bare minimum so that accessibility can work?

I say try to install normally or update them through the Google Play Store the following applications: https://play.google.com/store/apps/details?id=com.google.android.marvin.talkback

Voice Access - Apps on Google Play

Provides accessibility by voice for hands-free mobile computing.

play.google.com

Speech Recognition & Synthesis - Apps on Google Play

Speech recognition and synthesis for your device.

play.google.com

Everything will depend on how you configure the reading options and speed in the voice (Conversion of text to voice), touch and especially if you are going to use other accessibility options such as "Select to listen" or "TalkBack" itself requires specific settings for each user.

But if the installation from the Google Play Store doesn't work it will depend on the choices of the type of gapps you want. Generally better to use opengapps with the correct variant choices (full; stock or super). If you want to try this here is the link to the opengapps:

Home

The main repository of the Open GApps Project. Contribute to opengapps/opengapps development by creating an account on GitHub.

github.com

Stock Package

The main repository of the Open GApps Project. Contribute to opengapps/opengapps development by creating an account on GitHub.

github.com

Package Comparison

The main repository of the Open GApps Project. Contribute to opengapps/opengapps development by creating an account on GitHub.

github.com

But if you want something more unique for the applications you want then you will have to ask an experienced person to create a zip patch or edit the opengapps zip file so that it installs only the desired applications.

You can try the Aroma variant if it's interesting. Read this:

Aroma Package

The main repository of the Open GApps Project. Contribute to opengapps/opengapps development by creating an account on GitHub.

github.com

Advanced Features and Options

The main repository of the Open GApps Project. Contribute to opengapps/opengapps development by creating an account on GitHub.

github.com

About Flamegapps you need to ask someone to read the first post with the correct instructions/Notes and even try the Addon Packages option and in addition do the step to edit the flamegapps-config.txt file.

https://xdaforums.com/t/gapps-arm64-flamegapps-for-android-10-0-11-0-12-0-12-1.4020917/

In the case of the person I know, she uses the Conversion of text to voice option that creates a button so that the user can choose when and what they want to hear on the device. Furthermore, with the help of the Google assistant, it can set simple tasks to read messages automatically without the user having to touch the screen and even send or receive messages through an application that I will not mention here.

If you want to try this here is the link to the Google assistant: https://play.google.com/store/apps/details?id=com.google.android.apps.googleassistant&hl=en-US

Cheers