KDE has a system setting for a speech synthesizer and some extra sound and keyboard settings for people with disabilities, a magnification effect for selected areas of the desktop -- and not much more. What it lacks is an extensive screen reader like GNOME's Orca, which is coming close to equaling proprietary solutions and already makes computer use possible for thousands, particularly through its Braille support.
GNOME has done a thorough job of making its programs accessible through the Assistive Technology Service Provider Interface (AT-SPI), most recently through cooperation with Mozilla. Given the cross-platform cooperation that goes on at Freedesktop.org, I have to wonder why there's so little visible effort to get AT-SPI to support the Qt toolkit on one hand and to make KDE more accessible on the other hand.
Granted, accessibility is a long-term project. It took Orca three years to reach its present status, and that was with corporate support from Sun Microsystems. Yet the longer accessibility is delayed, the more its relative absence is going to become obvious and the harder it will be to implement. A redesign like KDE 4 would have been an ideal time to give such considerations higher priority.
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KDE 4 and the User Experience
In Classic KDE, you can not only drag and drop an icon between all the major parts of the desktop, but choose whether you wanted a new copy of the icon, or simply a link to the original. So far, the same functionality is missing from KDE 4.
Instead, you have separate menus for adding widgets or icons to both the desktop and the panel, with the option of selecting from the main menu as well. The system feels redundant and clumsy compared to what KDE offered before.
KDE's default widgets have always been fewer and more utilitarian than GNOME's applets, and, while the selection varies between distros, to date KDE 4 seems to have even fewer.
While the new KDE includes the multiple clipboard Klipper by default, its selection is usually limited to such widgets as a color picker, a battery charge indicator, a dictionary, and start menus. The only really standout upon them is the file watch widget, which allows you to track the use of your files of choice. By comparison, GNOME comes with a brightness control for desktops and for inhibiting power management (which can crash some machines), as well as such everyday tools as the Deskbar search tool, Force Quit for removing malfunctioning programs, and Show Desktop for finding your way through a tangle of multiple windows or full-screen programs.
Even when less choices are considered, KDE's widgets seem sparse compared to GNOME widgets. Nothing in Extragear or SuperKaramba comes close to the functionality of GNOME tools like Tomboy, many of which started life as simple applets and are now far on the way to becoming full-fledged utilities.
KDE 4's one innovation is to permit larger version of widgets that fit on to panels on the desktop. This change is welcome enough for a few widgets such as an analog clock, and, if you add such items as a task manager or a system tray, you can partially compensate for the inability to use more than one panel. Otherwise, why clutter your desktop with minor applications that you only occasionally want? Like the side panel in Vista, the only purpose seems to reclaim the extra space gained by wide screen monitors on behalf of developers.
One of the advantages that KDE Classic had over GNOME was an initial wizard that allowed you to choose in a matter of seconds how much eye candy you wanted to run. If you insisted, you could make individual choices, but the wizard was a perfect tool for those who wanted to optimize performance without the tedium of wading through window after window of check boxes.
Lacking this feature, KDE 4 presents instead a series of individual settings. Most of them are available in System Settings, the replacement for the KDE Control Center, but some configuration options are also scattered in through the Settings, Administration, System, and Utilities menus.
Then, just to make the layout more confusing, many configuration choices for system hardware are in Administration. But some, like the keyboard and mouse, are in System Settings, while others, like mobile phones and palm pilots, are listed under Utilities -> Peripherals. You can justify a move away from the Control Center on the grounds that it was becoming massive, but some organization is needed simply to make configuration easier.
Moreover, if you care about your work environment at all, you will almost certainly want to move through them, despite all the time you will need. Lacking the classic wizard, in the distros I've seen, KDE 4 generally installs with mid-ranged settings. Among other things, this choice means that font anti-aliasing, is not nearly optimal, and could be hard on your eyes over long periods of use.