I happened to connect my Airpods to my computer today. It never occurred to me before that the screen reader wouldn't honour the play/pause feature. Like, there's literally a say all command within #NVDASR designed to start reading the screen without further interaction, and there's this globally-recognised multimedia shortcut in windows - part of myriad keyboards, headsets (even my wired 3.5mm earbuds send it) - that the screen reader just totally ignores.
@cachondo I can see the logic; I'm not sure if anyone has ever requested it. One thing to consider would be if a play pause button on your earphones or multimedia keyboard did say all / pause for NVDA, what would happen if other media was playing? You could say if you are on a YouTube window then let it control that, but what if you've got audio playing in the background while you work? Then what does it control? Just questions to answer. Please do create an issue hough: https://github.com/nvaccess/nvda/issues
nvaccess/nvda

NVDA, the free and open source Screen Reader for Microsoft Windows - nvaccess/nvda

GitHub
@NVAccess @cachondo I've thought about this over the years. When you're using the screen reader, are you playing something or are you reviewing? You'd somehow need to register that one command (ie., read all) as a play/pause command in the system. Does Windows even allow for this kind of control? Even if there's a global play/pause registration, does it then let you use whatever headphones you have to use this action? Or would NVDA need to control this?