Childhood adversity (e.g. abuse neglect or household dysfunction) is a common experience significantlycontributing to the leading causes of death and increased US economic health burdens. Childhood adversitycauses long-term alterations on the nervous endocrine and immune systems well into adulthood includingdampening of the neuropeptide oxytocin (OXT). A healthy OXT system facilitates responsive social engagementand promotes maternal-infant (M-I) synchrony (reciprocal gaze affect speech and touch). Optimal M-Isynchrony fuels early brain development and prevents low empathy disruptive behavior poor social adaptationcognitive deficits and psychopathology in children. We posit that mothers with childhood adversity will havemore difficulty with M-I synchrony due in part to a dampened OXT system and will benefit from interventionsthat improve responsive nurturing engagement by epigenetic regulation of the OXT system. Most interventionsare costly complex and time-consuming. We aim to fill this gap by testing whether a simple early behavioralintervention (ATVV) will improve OXT system function and M-I synchrony in mothers with childhood adversity.The ATVV (Auditory Tactile Visual Vestibular) is a 15-minute behavioral intervention consisting of infant-directed speech moderate touch massage eye to eye gaze and horizontal rocking. We extend the knownsuccess of ATVV with preterm infants to full-term infants. We will compare M-I synchrony at 3 postnatal monthsin 250 first-time mothers (and their full-term infants) randomized to apply ATVV daily from birth to 3 months (n =125) or receive infant care education in an attention control group (n = 125). We apply a rigorous measure ofM-I synchrony that micro-codes video-recorded M-I behavior quantifying shared gaze affect speech and touch.Coding requires only 3-minutes of interaction and is valid when infants can reliably interact starting by 3 monthsof age. We will also assess ATVV's effect on maternal and infant peripheral OXT level a known biomarker ofM-I synchrony. OXT levels relate to quality of M-I synchrony yet we extend this knowledge to identify anepigenetic role of the oxytocin receptor gene (OXTR). We will analyze maternal plasma for OXTR methylationOXTR gene expression OXTR protein and oxytocin peptide in late pregnancy and at 1 2 and 3 postnatalmonths (along with infant saliva OXT). In summary aims are to 1) determine effects of daily ATVV comparedwith an attention control group from birth to 3 postnatal months on behavioral and physiologic measures of M-Isynchrony in mothers with childhood adversity and 2) for the first time identify molecular mechanisms in theOXT system underlying M-I synchrony in maternal plasma. Regression based methods (including covariates)will assess ATVV effects on M-I synchrony and OXT measures and identify relations among M-I synchrony andoxytocin measures. Clustering methods will be used to discover molecular profiles. An early behavioralintervention that successfully promotes M-I synchrony in vulnerable women through epigenetic regulation of theOXT system can then be tested in a multi-site clinical implementation trial with other high-risk groups.