Purpose: This study examined the effects of expressive and receptive language levels on initiated and repaired communication acts by prelinguistic children with developmental disabilities. Method: In this descriptive study, participants were 45 children between the ages of 3 and 6 years who had severe delays in expressive communication. Some children communicated with 12 or fewer spoken words; others communicated exclusively with gestures and vocalizations. Participants also had delays in receptive language, and 41 of the 45 had below average IQ scores. The children participated in a scripted interaction with examiners that was designed to provide opportunities to initiate requests and comments, and to repair communication breakdowns. Videotapes of these interactions were later coded for analysis. Results: Regression models indicated that differences in children's expressive communication levels and receptive language scores significantly predicted children's commenting communication acts during the scripted interaction, even after the authors accounted for child IQ. Expressive communication level was also a significant predictor of initiated requests when the authors controlled for IQ. Expressive communication level contributed to the variance in children's repairs following communication breakdowns; however, this contribution was not significant. Conclusion: Differences in levels of prelinguistic communication development predict commenting abilities in children with developmental disabilities but do not appear to predict likelihood to repair communication breakdowns. (Contains 1 figure and 10 tables.)