Re: "Accessibility: Highlight spoken feature not working in Pages" ... "despite my settings being unchanged"
As Apple's essential feature is not working as expected, you might want to first try talking with the experts:
You may want to contact Apple's Accessibility Support Team:
How to contact Apple for accessibility support - Apple Support
or
Apple's Accessibility Support Website (You can "Get Support" from the link at the bottom of their website:) Accessibility Support - Official Apple Support
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Else: To try something on your own:
✽ First: Quit the "Pages" app: To quit an app, open the App Switcher, then swipe up on the app.
✽ Then: Restart your iPad: Restart your iPad - Apple Support (deletes temporary files, re-establishes connections, and more.)
✽ Next: Re-open Pages app : To reopen the app, go to the Home Screen (or the App Library), then tap the app.
✽ Finally: Check if the situation has been resolved.
More info. if needed: How to: Quit and reopen an app on iPad - Apple Support
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If you still need help:
Wondering which iPadOS version, and which version of "Pages" is installed on your iPad.
Sometimes updating to the newest compatible versions for your device may help resolve issues.
(If iOS updates are available, is always wise to back-up your device before updating.)
For iPadOS : To see if an update is waiting to be installed: Settings > General > Software Updates
For Pages app: Check for "updates" in the App Store: ie tap "Updates" in the sidebar to see if there's one.
All the best :-)