Attentional difficulties are evident in children with autism spectrum disorder (ASD). Accordingly, mothers of children with ASD may modify communication to direct their child's attention, and this pattern may generalize to later-born children. This study examined patterns of child-directed communication in 11 mothers of 18-month-old toddlers at heightened risk (HR) for ASD and compared them to 11 low-risk (LR; no first- or second-degree relative with ASD) dyads. Naturalistic interactions at home were coded for communication that captured, directed, or maintained children's attention and/or actions. Results provide preliminary evidence that LR mothers produce more utterances that involve labeling objects and gestures, while HR mothers use more suggestions. Thus, having an older child with ASD may influence maternal behavior with later-born children, even when those children do not themselves manifest obvious ASD symptomatology. Results highlight the need for further research on dyadic interactions between mothers and HR toddlers in larger samples.