A system comprising: a computer-readable memory storing executable instructions; and one or more processors in communication with the computer-readable memory, wherein the one or more processors are programmed by the executable instructions to at least: generate text to be presented to a user, wherein the text comprises a sequence of items; generate an audio presentation using the text; associate a plurality of identifiers with the sequence of items, wherein each item of the sequence of items is associated with at least one identifier of the plurality of identifiers; transmit, to a client device, the audio presentation and the plurality of identifiers; receive, from the client device: audio data comprising a user utterance; and one or more identifiers of the plurality of identifiers, wherein each identifier of the one or more identifiers is transmitted by the client device as each identifier is encountered during playback of the audio presentation at the client device, and wherein a first identifier of the one or more identifiers corresponds to a most recent identifier encountered during playback of the audio presentation at the client device; perform speech recognition on the user utterance to obtain speech recognition results; identify a first item, of the sequence of items, based at least partly on the first identifier and the speech recognition results; and perform an action based at least partly on the first item. a computer-readable memory storing executable instructions; and one or more processors in communication with the computer-readable memory, wherein the one or more processors are programmed by the executable instructions to at least: generate text to be presented to a user, wherein the text comprises a sequence of items; generate an audio presentation using the text; associate a plurality of identifiers with the sequence of items, wherein each item of the sequence of items is associated with at least one identifier of the plurality of identifiers; transmit, to a client device, the audio presentation and the plurality of identifiers; receive, from the client device: audio data comprising a user utterance; and one or more identifiers of the plurality of identifiers, wherein each identifier of the one or more identifiers is transmitted by the client device as each identifier is encountered during playback of the audio presentation at the client device, and wherein a first identifier of the one or more identifiers corresponds to a most recent identifier encountered during playback of the audio presentation at the client device; perform speech recognition on the user utterance to obtain speech recognition results; identify a first item, of the sequence of items, based at least partly on the first identifier and the speech recognition results; and perform an action based at least partly on the first item. generate text to be presented to a user, wherein the text comprises a sequence of items; generate an audio presentation using the text; associate a plurality of identifiers with the sequence of items, wherein each item of the sequence of items is associated with at least one identifier of the plurality of identifiers; transmit, to a client device, the audio presentation and the plurality of identifiers; receive, from the client device: audio data comprising a user utterance; and one or more identifiers of the plurality of identifiers, wherein each identifier of the one or more identifiers is transmitted by the client device as each identifier is encountered during playback of the audio presentation at the client device, and wherein a first identifier of the one or more identifiers corresponds to a most recent identifier encountered during playback of the audio presentation at the client device; audio data comprising a user utterance; and one or more identifiers of the plurality of identifiers, wherein each identifier of the one or more identifiers is transmitted by the client device as each identifier is encountered during playback of the audio presentation at the client device, and wherein a first identifier of the one or more identifiers corresponds to a most recent identifier encountered during playback of the audio presentation at the client device; perform speech recognition on the user utterance to obtain speech recognition results; identify a first item, of the sequence of items, based at least partly on the first identifier and the speech recognition results; and perform an action based at least partly on the first item.