Giving and representational gestures were produced at a lower rate by ELGA infants.
Pointing gestures and words were produced by a lower percentage of ELGA relative to FT infants.
Less advanced motor and cognitive skills were found in ELGA relative to FT infants.
Pointing and representational gestures were related to fine motor skills in the ELGA group.
Clinical assessment must address spontaneous communicative behaviors and fine motor skills.