She is an older lady who only knows to shut it off. it happened yesterday and again today.

How is she restarting the PC?  And that's a serious question, as Restart always forces Windows to reload from scratch from the disk, while doing a Shutdown and powering up again may not if Fast Startup is enabled on the system.

Though restarting is the first of the things to do in, The Most Basic Troubleshooting Steps for Suspected NVDA Issues, it's always worth doing the remaining two, though in this case I am doubtful this will result in a fix.  You just never know.

It sounds like the often-used technique of checking, unchecking, then checking the option again has already been tried and not worked.

Beyond that, my only recommendation would be an uninstall and reinstall of NVDA.  If that's not viable, and she knows the NVDA startup keyboard command, then keep using that for the time being.
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Brian - Virginia, USA  - Windows 10, 64-Bit, Version 22H2, Build 19045  

There are many people who can only make themselves feel better about themselves by making themselves feel better than others.

    ~ Commenter Looking_in on the Washington Post, 7/10/2014

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Sometimes I think I understand everything,  and then I regain consciousness. 
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