Children's gesture production precedes and predicts language development, but the pathways linking these domains are unclear. It is possible that gesture production assists in children's developing word comprehension, which in turn supports expressive vocabulary acquisition. The present study examines this mediation pathway in a population with variability in early communicative abilities--the younger siblings of children with autism spectrum disorder (ASD; high-risk infants, HR). Participants included 92 HR infants and 28 infants at low risk (LR) for ASD. A primary caregiver completed the MacArthur-Bates Communicative Development Inventory (Fenson, et al., 1993) at 12, 14, and 18 months, and HR infants received a diagnostic evaluation for ASD at 36 months. Word comprehension at 14 months mediated the relationship between 12-month gesture and 18-month word production in LR and HR infants (ab = 0.263; p < 0.01). For LR infants and HR infants with no diagnosis or language delay, gesture was strongly associated with word comprehension (as = 0.666; 0.646; 0.561; ps < 0.01). However, this relationship did not hold for infants later diagnosed with ASD (a = 0.073; p = 0.840). This finding adds to a growing literature suggesting that children with ASD learn language differently. Furthermore, this study provides an initial step toward testing the developmental pathways by which infants transition from early actions and gestures to expressive language.