I'd be most hopeful for a solution from AssistiveWare if Apple doesn't
come through with improvements to VoiceOver with Leopard.  From
the descriptions by  David Niemeijer their GhostReader Text-to-Speech
software can do navigation by paragraphs and sentences, with the
option to repeat.

Here's a section from his response on September 15 on the subject
of ghost reader and InfoVox iVox:

GhostReader is currently slightly ahead of VisioVoice with functions   
to go back to the start of a sentence or skip to the next paragraph   
or sentence. These will probably added to VisioVoice 1.2 in the   
future. Basically, these two applications will be feature hopping a   
bit with regard to their reader functionality with sometimes a new   
feature appearing in one first and sometimes in the other first. 


Cheers,

Esther

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