Hi terriergal,
Welcome to the Apple Community.
Re: spoken text: skips words constantly
Sorry I'm no expert in this area, yet your request surely deserves a response.
I don't know whether this suggestion will help, or not.
With VoiceOver,
Your iPhone uses a compact voice for VoiceOver, Speak Screen, and Speak Selection.
And you have a few other options for the voices that you can use for speech.
Seems you can also switch between Default and Enhanced Quality
ot
Perhaps slowing down the rate / speed of spoken text may help:
Adjust voice and speed for VoiceOver and Speak Screen on your iPhone, iPad, or iPod touch - Apple Support
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Wondering which iOS version you are using on your iPhone, and if an update can help you.
(To find the iOS software version installed on your device, go to Settings > General, then tap About).
You may want to update to the latest version, iOS 16.2, as there have been several updates since iOS 16 release..
About iOS 16 Updates - Apple Support
How to: Update your iPhone or iPad - Apple Support
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There's a video online about spoken text that may provide some useful tips:
https://www.iaccessibility.com/videos/apple-support/index.cgi/video?ID=331
Or
For support from Apple if needed
How to contact Apple for accessibility support - Apple Support
Or
Apple's Accessibility Support Website
Accessibility Support - Official Apple Support
All the best :-)