Click the Settings button on the toolbar. Settings are arranged in seven tabs. Changes take effect straight away and are remembered.

Speech

Voice
Any voice installed on your Mac, or System default. See Choosing a Voice.
Rate / Pitch / Volume
0.5×–2.0×, 0.5–2.0, 0–100%. Greyed out for voices that set their own.
Silent mode (disable all TTS)
Mutes all speech. See Silent Mode.
Test voice
Plays a test phrase.
Echo
Speak each letter as you type (Key Echo) — off; Speak each completed word as you type — off; Speak dictated phrase back when listening stops — on. See Key Echo and Voice Echo.

Reading

Require Ctrl/Option for hover-speak
On by default. See Hover Read Modes.
Speak when text is selected
Off by default. See Speak on Select.
Speak text captured by Text extractor
On by default. See Text Extractor.
Visual tracking
Underline each word as it is spoken (on), Underline colour (red), Thickness (3 px). See Word Underline.

The hover mode itself is chosen from the Hover ▾ dropdown on the toolbar.

Banner

Show the spoken-text banner
Off by default.
Background / Text colour / Font / Font size / Words at a time / Underline the currently spoken word
See Spoken-Text Banner.

Predict

Predictions
Off by default.
Auto-correct obvious typos as you type
Off by default.
Profanity filter
On by default. See Word Prediction and Autocorrect.

Ambient

Sound
Off, or one of 15 sounds. See Ambient Sounds.
Volume — While speaking / While idle
15% / 45% by default.
Music and Spotify
Dim Music and Spotify while speaking (off), Dim to (30%). See Dim Music and Spotify.

Toolbar

Show the floating toolbar
On by default.
Position
Track window or Static (default).
Colour mode
Black & white (default), Blue or Colours.
Orientation
Horizontal (default) or Vertical.
Size
Small (default) or Large.
Keyboard shortcuts
A reminder of the main shortcuts. See Keyboard Shortcuts Reference.

About

Help…
Opens the Readable help.
Re-check permissions…
See Installing and Permissions.
Reset all settings to defaults
Puts every setting back to how it was when Readable was installed.
Version
The version and build number — quote this when contacting support.
About tab of Settings with Help, Re-check permissions and Reset all settings to defaults buttons, and the version number v2.0 (8).
Settings → About, with Help, Re-check permissions, Reset all settings to defaults, and the version number.