This study attempted to elicit distal gestures within dynamic assessment structured sampling events from six children with moderate to severe intellectual disability (ages 8-13). Using four communication temptations and a least-to-most prompting hierarchy across three sessions, three participants who had both pre-symbolic and preintentional communication demonstrated an initial distal gesture, often in response to a choice making temptation. Clinical implications are discussed with regard to the utility of dynamic assessment structured sampling activities.