It may be worthwhile directly contacting Apple Support - and ask to speak with an Accessibility Specialist. Apple have a team dedicated to offering support for accessibility issues. They will be able to offer help and support with suggestions and specific settings for users with difficulties with all forms of disability.
You can contact Apple Support using the Get Support link at top-right of this page. Alternatively, you can initiate contact, or open a support case, using the excellent Apple Support App. If not already installed on your iPad, the App can be downloaded from the App Store:
https://apps.apple.com/gb/app/apple-support/id1130498044
I hope this information is helpful in obtaining any specialist help that you may need.