Screen reader support in canvas apps is messy, and PixiJS's AccessibilitySystem handles it by creating an invisible shadow DOM overlay that mirrors your interactive containers. The defaults are conservative: nothing happens until the user presses Tab, and mouse movement kills the overlay again, which makes testing annoying but assumes keyboard users don't touch mice. Set enabledByDefault and deactivateOnMouseMove to false if you're serious about it. The hook is a tabIndex property on containers plus accessibleTitle and accessibleHint strings, and you still need eventMode for the click events to route properly. Works on mobile via a hidden touch hook, doesn't work in Web Workers.
npx skills add https://github.com/pixijs/pixijs-skills --skill pixijs-accessibility