Being someone who has hand-coded websites, I can say with a fair degree of confidence that it takes more to break screen reader accessibility than it takes to make it. The easy site is actually more compliant as well. The exception to this rule is of course the old text-based browsers that don't handle HTML5 well. In order to make an audio or video file playable in text-based browsers, I ended up having to essentially write my code twice, once with the audio or video tag that generates a nice player that is accessible to screen readers in graphical browsers, and then once more to offer a download link complete with a title and all so that people with older browsers could download and play the same file. But that was the only place where I had significant trouble. My hand-coded websites are 100% screen reader accessible, at least according to my own tests, and I don't know, but I hope that they are at least somewhat visually appealing as well.