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This study examines the multimodality of mother-child interaction during the reading of bilingual picture books. Based on a sociocultural theoretic frame, this case study documents the physical, linguistic, and paralinguistic behaviors of four Korean mothers who conducted picture book reading in English and Korean with their preschool bilingual children. Using a Qualitative Analysis Software called Transana, mother-child interaction video files were collected, transcribed, and organized, and analytic codes were applied to the visual data. Key behavioral patterns were analyzed cross-linguistically and cross-culturally.