OK, you've convinced me - Wx::Perl is worthy of investigation. I've just had a look at the WxWidgets site and it appears that accessibility is something that is being worked on.

Even if it's not there are the moment, the issue is being acknowledged and addressed which gives me hope that this could be the path for future accessible Perl GUI applications. (That is assuming that the Perl module is sufficiently transparent, but I'm sure that this could be fixed easily enough if it were not.)

I am now wondering about Tk again; further research has shown that Tk is MSAA-compliant, so accessibility has been addressed in the underlying toolkit. Whether the Perl Tk module is missing implementation of methods or if mention is simply missing from the man pages is something I'll have to investigate when I get the time.

I will, however, be looking at Wx in the first instance as the underlying project looks to be more 'fresh' than Tk.