From: James Jolley on
This one is urgent. If anyone using VoiceOver in conjunction with any
of the iTunes audio plugins such as iWow or others, voiceOver crashes
even though iTunes is sometimes not even running.

What appears to happen is that the audio plugin gets confused for an
output device and VoiceOver attempts to use it. I'm not sure why that
is, what the problem is or anything, but I had many crashes with
VoiceOver since trying both the iWow and the Bonjovi Acoustics ones,
proving that it is iTunes's own plugin architecture that is at fault.
I'm guessing that iTunes doesn't unload the plugins correctly, or even
do so when the audio is paused. Either way, until Apple can come up
with a fix, VoiceOver seems to cause problems and i've personally
stopped using any audio add in.

-James-