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Many people with aphasia have a strong desire to participate in reading activities despite persistent reading challenges. Digital reading devices and text-to-speech (TTS) technology are increasing in popularity and have the potential to help people with aphasia. Systematic investigation of modifiable TTS features provides a means of exploring this potential. This study's aim was to evaluate the effect of digital highlighting synchronised with TTS auditory and written output on reading comprehension by people with aphasia and to determine their highlighting preferences. This work was registered with clinicaltrials.gov and assigned the clinical trial registry number 01446 r prior to initiation of data collection. Twenty-five adults with aphasia read and listened to passages presented in three synchronised highlighting conditions: sentence highlighting, single word highlighting, and no highlighting. Participants answered comprehension questions, selected most and least preferred conditions, and provided feedback explaining highlighting preferences. Comprehension accuracy did not vary significantly across presentation conditions, but participants preferred either single word or sentence highlighting over no highlighting. Neither word nor sentence highlighting benefitted or hindered comprehension by people with aphasia as a group, but individual differences may occur. Clinicians should attend to personal preferences when implementing digital highlighting as a reading support strategy. [ABSTRACT FROM AUTHOR]