Prelinguistic behaviors—such as gaze shift, facial expressions, reaching, pointing, vocalizing, and body language—may represent a viable and effective communication strategy for some people with severe disabilities. This chapter considers the distinction between prelinguistic and linguistic communication, describes a range of prelinguistic skills reportedly used by people with severe disabilities, and reviews intervention literature aimed at enhancing prelinguistic communication. The reviewed literature supports the use of interventions based on naturalistic developmental behavioral principles for increasing the prelinguistic skills and related language abilities of young children with autism and developmental delay/disability. Limitations of the literature are discussed and indications for the use of prelinguistic interventions are considered.