Ability to change the voice - both pitch and speed - on the text to speech feature.
Students with text to speech accommodations should have the ability to choose the speed at which the text is delivered as well as the pitch of the voice (male vs female).
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Mike L. Miller commented
Many students with reading challenges are extremely adept with receptive or productive language or both. The optimal speed for listening is highly variable strong receptive language abilities... and the slow default pace of the reader can actually be a barrier to comprehension. I'm not as certain about the importance of pitch (or sex?), and I worry about anxious students avoiding the testing by fiddling with such things if they have too many options. But speed adjustability definitely feels critical!