Choosing a screen reader
NVDA is free and open source on Windows and works very well for coding. JAWS is a powerful commercial option on Windows. VoiceOver is built into macOS and needs no installation.
Whichever you choose, spend time learning its keyboard commands for reading line by line and navigating by heading, because you will use them constantly while coding.
Configuring Visual Studio Code
VS Code has strong built-in accessibility. Open the Command Palette with Control Shift P, or Command Shift P on macOS, and search for settings.
Set the option editor.accessibilitySupport to on. This tells the editor a screen reader is active and enables clearer announcements.
Turn on the setting that announces errors and warnings, and enable audio cues so you hear when a line has an error, a breakpoint, or a folded region.
Everyday habits that help
Use the integrated terminal inside VS Code, opened with Control backtick, so your editor and command line stay in one place.
Navigate code by symbols with Control Shift O to jump between functions and classes without scrolling line by line.
Keep line numbers announced so you always know your position, and rely on the Problems panel to review all errors in one list.