In the busy hallways of the Neonatal Intensive Care Unit at Niswonger Children’s Hospital, every movement is a milestone. For many infants born in the Appalachian region, those first few days of life are a high-stakes transition. The opioid epidemic has affected the area significantly, creating an urgent need for research into how prenatal exposure impacts the youngest members of the community. While most people see a newborn’s twitch or a steady gaze as simple biology, Dr. Alyson Chroust sees a complex data map of the future.
Dr. Chroust, an experimental psychologist and the chair of the Department of Psychology at ETSU, has spent her career investigating the invisible ripples left by prenatal opiate exposure. Her work is a blend of rigorous data analysis and deep community advocacy, aimed at ensuring that for these infants, a difficult start does not dictate their entire story.
When Dr. Chroust began her research, the prevailing medical wisdom suggested a clear hierarchy of risk. Scientists assumed a “stair-step” model of development: infants with no exposure would develop typically, those with moderate exposure would face some challenges, and those diagnosed with Neonatal Abstinence Syndrome (NAS), requiring pharmacological treatment, would face the most significant delays.
However, her findings at the Johnson City Medical Center challenged that assumption. “We found there was no difference between the two opiate exposure groups,” Dr. Chroust explains.
Whether an infant was treated for withdrawal in the NICU or was discharged after a standard observation period, their motor development scores were equally impacted. This discovery serves as a critical early warning signal for providers: even without a formal NAS diagnosis, infants exposed to opiates prenatally remain at high risk for developmental delays.
Understanding the first 30 days of life was only the beginning. Dr. Chroust’s curiosity naturally turned to the long-term: what happens after these families leave the hospital?
This question led her to a vital collaboration with the Baby Steps Clinic, a specialized follow-up program. The clinic operates on a revolutionary “one-stop-shop” model where an interdisciplinary team, including physical therapists, occupational therapists, speech pathologists, and audiologists, sees the child and family all at once.
“It’s an amazing clinical delivery model,” Dr. Chroust says. “I wanted to study what they’re doing and understand the impact. Are we seeing improved outcomes? Are families getting more confident in their parenting?”
Through a recent Opiate Abatement Council Grant, the team successfully expanded the clinic hours of operation, doubling the number of families who can receive life-changing early interventions. The impact of this work extends far beyond the laboratory, providing a vital resource for the Johnson City community and the broader Appalachian region. By connecting clinical care with academic research, ETSU is fostering an environment where scientific breakthroughs directly improve the quality of life for local families.
Now in her second year as department chair, Dr. Chroust utilizes her leadership role to support this mission by helping faculty and students find similar collaboration opportunities across campus. Her goal is to elevate research that addresses the unique challenges of the region while mentoring the next generation of professionals.
For Dr. Chroust, research and leadership are both about asking better questions. While her data shows that motor performance may be impacted early on, she is now mapping out how language and cognition emerge as these children reach school age.
“There are always more questions than answers,” Dr. Chroust admits. But in the world of developmental psychology, those questions are the key to unlocking better support, earlier interventions, and brighter futures for families in the Appalachian region.
