Index: wp-admin/includes/nav-menu.php
===================================================================
--- wp-admin/includes/nav-menu.php	(revision 23505)
+++ wp-admin/includes/nav-menu.php	(working copy)
@@ -89,7 +89,7 @@
 		<li id="menu-item-<?php echo $item_id; ?>" class="<?php echo implode(' ', $classes ); ?>">
 			<dl class="menu-item-bar">
 				<dt class="menu-item-handle">
-					<span class="item-title"><?php echo esc_html( $title ); ?> <span class="is-submenu" <?php echo $submenu_text; ?>><?php _e( 'sub item' ); ?></span></span>
+					<span class="item-title"><span class="menu-item-title"><?php echo esc_html( $title ); ?></span> <span class="is-submenu" <?php echo $submenu_text; ?>><?php _e( 'sub item' ); ?></span></span>
 					<span class="item-controls">
 						<span class="item-type"><?php echo esc_html( $item->type_label ); ?></span>
 						<span class="item-order hide-if-js">
Index: wp-admin/js/nav-menu.js
===================================================================
--- wp-admin/js/nav-menu.js	(revision 23505)
+++ wp-admin/js/nav-menu.js	(working copy)
@@ -53,6 +53,8 @@
 			this.initAccessibility();
 
 			this.initToggles();
+
+			this.refreshVerbalAccessibility();
 		},
 
 		jQueryExtensions : function() {
@@ -264,6 +266,80 @@
 			});
 		},
 
+		countMenuItems : function( depth ) {
+			return $( '.menu-item-depth-' + depth ).length;
+		},
+
+		refreshVerbalAccessibility : function() {
+			$( '.item-edit' ).each( function() {
+				var $this = $(this),
+					movement = [],
+					availableMovement = '',
+					menuItem = $this.parents( 'li.menu-item' ),
+					depth = menuItem.menuItemDepth(),
+					isPrimaryMenuItem = ( 0 === depth ),
+					itemName = $this.parents( '.menu-item-handle' ).find( '.menu-item-title' ).text(),
+					position = parseInt( menuItem.index() ),
+					totalMenuItems = $('#menu-to-edit li').length,
+					hasSameDepthSibling = menuItem.nextAll( '.menu-item-depth-' + depth ).length;
+
+				// Where can they move this menu item?
+				if ( 0 !== position )
+					movement.push( 'up' );
+
+				if ( position + 1 !== totalMenuItems && 0 !== position )
+					movement.push( 'down' );
+
+				if ( 0 === position && 0 !== hasSameDepthSibling )
+					movement.push( 'down' );
+
+				if ( ! isPrimaryMenuItem )
+					movement.push( 'left' );
+
+				if ( 0 !== position ) {
+					if ( menuItem.find( '.menu-item-data-parent-id' ).val() !== menuItem.prev().find( '.menu-item-data-db-id' ).val() )
+						movement.push( 'right' );
+				}
+
+				for ( i=0; i<movement.length; i++ ) {
+
+					if ( 1 !== movement.length && i + 1 === movement.length )
+						availableMovement = availableMovement + ' or';
+
+					availableMovement = availableMovement + ' ' + movement[i] + ',';
+				}
+
+				availableMovement = availableMovement.substring(0, availableMovement.length - 1);
+
+				if ( isPrimaryMenuItem ) {
+					var primaryItems = $( '.menu-item-depth-0' ),
+						itemPosition = primaryItems.index( menuItem ) + 1,
+						totalMenuItems = primaryItems.length,
+
+						// String together help text for primary menu items
+						title = itemName + '. ' + api.getGetOrdinal( itemPosition ) + ' of ' + totalMenuItems + ' primary menu items.  Move this item' + availableMovement + '.';
+				} else {
+					var parentItem = menuItem.prevAll( '.menu-item-depth-' + parseInt( depth - 1 ) ).first(),
+						parentItemId = parentItem.find( '.menu-item-data-db-id' ).val(),
+						parentItemName = parentItem.find( '.menu-item-title' ).text(),
+						subItems = $( '.menu-item .menu-item-data-parent-id[value="' + parentItemId + '"]' ),
+						itemPosition = $(subItems.parents('.menu-item').get().reverse()).index( menuItem ) + 1,
+						totalMenuItems = subItems.length;
+
+						// String together help text for sub menu items
+						title = itemName + '. ' + api.getGetOrdinal( itemPosition ) + ' of ' + totalMenuItems + ' subb menu items under ' + parentItemName + '. Move this item' + availableMovement + '.';
+				}
+
+				$this.prop('title', title);
+			});
+		},
+
+		getGetOrdinal : function(n) {
+			var s=["th","st","nd","rd"],
+				v=n%100;
+			return n+(s[(v-20)%10]||s[v]||s[0]);
+		},
+
 		initAccessibility : function() {
 			$( '.item-edit' ).off( 'focus' ).on( 'focus', function(){
 				$(this).on( 'keydown', function(e){
@@ -320,9 +396,9 @@
 						if ( thisItemChildren ) {
 							var items = thisItem.add( thisItemChildren );
 							// Move the entire block
-							items.detach().insertBefore( menuItems.eq( newItemPosition ) );
+							items.detach().insertBefore( menuItems.eq( newItemPosition ) ).updateParentMenuItemDBId();
 						} else {
-							thisItem.detach().insertBefore( menuItems.eq( newItemPosition ) );
+							thisItem.detach().insertBefore( menuItems.eq( newItemPosition ) ).updateParentMenuItemDBId();
 						}
 						break;
 					case 'down':
@@ -341,7 +417,7 @@
 							if ( menuItemsCount === thisItemPosition + items.length )
 								break;
 
-							items.detach().insertAfter( menuItems.eq( thisItemPosition + items.length ) );
+							items.detach().insertAfter( menuItems.eq( thisItemPosition + items.length ) ).updateParentMenuItemDBId();
 						} else {
 							// If next item has sub items, shift depth
 							if ( 0 !== nextItemChildren.length )
@@ -350,7 +426,7 @@
 							// Have we reached the bottom
 							if ( menuItemsCount === thisItemPosition + 1 )
 								break;
-							thisItem.detach().insertAfter( menuItems.eq( thisItemPosition + 1 ) );
+							thisItem.detach().insertAfter( menuItems.eq( thisItemPosition + 1 ) ).updateParentMenuItemDBId();
 						}
 						break;
 					case 'left':
@@ -358,6 +434,7 @@
 						if ( 0 === thisItemDepth )
 							break;
 						thisItem.shiftHorizontally( -1 );
+						$( '#menu-name' ).focus();
 						break;
 					case 'right':
 						// Can't be sub item at top
@@ -367,9 +444,11 @@
 						if ( thisItemData['menu-item-parent-id'] === prevItemId )
 							break;
 						thisItem.shiftHorizontally( 1 );
+						$( '#menu-name' ).focus();
 						break;
 					}
 					api.registerChange();
+					api.refreshVerbalAccessibility();
 					// Put focus back on same menu item
 					$( '#edit-' + thisItemData['menu-item-db-id'] ).focus();
 					return false;