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I work with a disabled person who uses their communication-aid to control their iMac through keyboard and mouse commands.
I'm setting up keyboard shortcuts to launch applications directly using services in Automator, however the communication-aid doesn't have the ability to send the command key.
How can I get OSX to recognise other key combinations? (e.g. ctrl-alt-f to launch FireFox)
Use Apple's automator and save the result as a service. If you select the right conext for the service it will appear in the right click menu. You can add shortcuts to services using System Preferences > Keyboard > Keyboard shortcuts. Click somewhere to the right of the service name (near the right edge of the white box). A field appears and you can type a shortcut. This is not very intuitive.
While there is a contextual menu for Speech ยป Start speaking that will speak the selected text, it requires navigating several menus. If you want to be able to speak the selection without navigating menus, create an automator service that receives text in any application. Give it a single action: Run shell script. The shell script is utterly simple: /usr/bin/say (it will take the argument of what to say from stdin, which in this case will be the selected text). Save the service (I called it "Say paragraph").
Then, in System Preferences, you can assign this action a keyboard shortcut (I gave it the keystroke ControlShift1). So triple click, then ControlShift1 and it speaks what's under the mouse pointer.
Best Answer
This article explains how to customize keyboard shortcuts.