Features are disclosed for generating markers for elements or other portions of an audio presentation so that a speech processing system may determine which portion of the audio presentation a user utterance refers to. For example, an utterance may include a pronoun with no explicit antecedent. The marker may be used to associate the utterance with the corresponding content portion for processing. The markers can be provided to a client device with a text-to-speech (“TTS”) presentation. The markers may then be provided to a speech processing system along with a user utterance captured by the client device. The speech processing system, which may include automatic speech recognition (“ASR”) modules and/or natural language understanding (“NLU”) modules, can generate hints based on the marker. The hints can be provided to the ASR and/or NLU modules in order to aid in processing the meaning or intent of a user utterance.