In most games the issue is normally not using voice attack, but trying to convince the system that a button being held for the same length of time every time isn't a bot. It's well and good for a mod or a dev to say they endorse the use of voice attack, but then you're banned accidentally for giving a command to hold down W for two seconds or half a second at a time every time that makes things difficult.
As far as the more difficult selections, voice attack allows you to select a spot on the screen to be clicked on command. This is great for navigating frequently used menus and making selections. So I can program it for her to say "items" to press button 3 and then "item one" to throw a pokeball. The issue is that "item one" or "item five" for a potion is always selected at the same spot. Which usually would cause an issue.