Here's my attempt at it, there's no setting of any options, but speech works (if it's installed of course)
Code:
ctcp *:speech:*:{
  echo -atic ctcp $+([,$nick SPEECH]:) $2-
  sapi.talk $regsubex($nick,/[^\w]/g,) says: $iif($2,$2-,nothing)
}
alias sapi.talk {
  var %s = Spk. $+ $ticks,%a = $iif($1,$1-,I've got nothing to say!)
  .comopen %s SAPI.SpVoice
  if !$comerr { .comclose %s $com(%s,Speak,3,bstr,%a) }
}