Kinect voice support is included in the latest Skyrim Xbox 360 update.
With the Kinect enabled, 200 commands may be issued using voice alone, including hotkey assignments, directions to followers, inventory and map navigation and manipulation, barter, and more - see the images below for a full list.
Shouts may be made in English or Dragon, the latter requiring the player to hold the right bumper while speaking. Receiving mockery from flatmates is context-sensitive.
French, Italian, German and Spanish versions of the patch are still in testing.