By its name, I misunderstood what shouldGroupAccessibilityChildren does the first time I saw it. It can be used for VoiceOver to traverse all items in a view before moving to the next one, instead of grouping as in combining those elements.

VoiceOver traverses elements in the natural reading order, from left to right, top to bottom, in left-to-right languages. Sometimes data is displayed in columns, so that order might not be the most logical one.
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If you have interactions that are hidden or require complex gestures to be performed or that may conflict with VoiceOver, you need to provide alternative ways of executing these actions. Custom actions can help a lot of times, but not always.

Too much data can overwhelm users. Very little is an incomplete experience. It is hard to find a balance on verbosity and the users may have different preferences. To help with this issue, the AXCustomContent APIs let you mark data as optional.

A common example where you need to manually configure the button accessibility trait is for some table/collection view cells. These tend to be “buttons” that perform an action, like playing music, or bring the user to a different screen.