JOHNSON CITY — Researchers at East Tennessee State University are beginning a study looking at ways visual processing and motor development in newborns might be affected by prenatal opioid exposure.

Dr. Alyson Chroust, a cognitive developmental psychologist and assistant professor in the Department of Psychology, is leading this study, which is funded by a $10,000 grant from ETSU’s Research Development Committee.

Chroust and her team are recruiting families with newborns from 12 hours old to those who need to stay in the NICU (neonatal intensive care unit) at the Niswonger Children’s Hospital at Johnson City Medical Center. Chroust explained that sometimes, opioid-exposed infants exhibiting the withdrawal and other symptoms of neonatal abstinence syndrome (NAS) may stay in the hospital for a few days while they are being monitored and potentially treated for NAS.

With the consent of the parents, the researchers will conduct a series of tests on both opioid-exposed and non-opioid-exposed infants, with both groups of infants completing the same tasks.

Chroust says that people are often surprised that cognitive skills can be tested at such an early stage.

“It’s really simple, when you think about it,” she said.  “I’ll have the moms hold the newborn babies on their laps, supporting their necks, and have the babies look at some pictures on a computer screen for me. We basically show them two pictures side-by-side, using a little video camera that’s on top of the monitor to record where their eyes are looking. Are they looking at the picture on the left side or the one on the right side? Based on how long the newborns look to one picture versus the other, it lets me know what they’re remembering about those pictures, based on what we showed them previously. Or maybe it lets me know something about their preferences for different types of pictures.”

Chroust said that she will be specifically monitoring how the infants process spatial information, such as the spatial relations between facial features or the relationship between a rectangle and a square.

“Looking at the shapes is not nearly as exciting for the babies as looking at the faces,” she said, “but it gives you a good contrast for the different types of pictures, one being something that’s very social, which is the face, and something that is not, which is the regular shapes.”

Her co-investigator, ETSU Department of Physical Therapy faculty member Dr. Kara Boynewicz, will conduct motor development assessments on the newborns that are similar to tests the physicians do, such as testing their reflexes and flexibility.

In conjunction with these tests, the parents or primary caregivers will be asked to complete questionnaires that will give the researchers such information as prenatal care, the home environment the infant will be raised in, socioeconomic status, educational background, and how the mother or caregiver has bonded with the infant in a short period of time.

“It’s a good collection of information just to give us a whole picture of development instead of just snapshots of their cognitive and motor skills,” Chroust said. “We want to know about the family context, too.”

This research continues the work Chroust began while writing her dissertation at the University of Kentucky, where she earned her Ph.D. in 2017.

“My dissertation was looking at something similar with opioid-exposed infants and another group of healthy infants and trying to compare those two groups to see if there really are differences,” she said. “I found out that no one is really doing that work at this newborn age. No one’s really trying to understand or investigate if there are any cognitive differences or if these two groups are really similar at this age. It’s not until they’re maybe 5 or 6 — school-age — that you really start to see some of these behavioral or cognitive differences emerge between the groups.”

Chroust also noted that this will be one of the first studies to look at cognitive and motor tasks at the same time.

“We’re really interested to see if the infants’ cognitive and motor development are correlated,” she said. “If we’re seeing an infant with strong scores on cognitive tasks, do they also have really high motor development? Or if they’re having low cognitive, are they also showing low motor scores? Are they working together or against each other, or developing at the same time?”

The research team, which also includes neonatologist Dr. Shawn Hollinger of the Department of Pediatrics in ETSU’s Quillen College of Medicine, hopes to use the results of this and subsequent research — if differences between the groups are found — to design intervention methods to help affected infants with low cognitive and motor skills to improve.

“A lot of the research is showing that if you see differences early on, the earlier you intervene, the better the long-term outcomes are for those kids,” Chroust said. “So if we can do some type of intervention within the first six months or year of life, we may then no longer see differences at older ages; so when they’re entering schools, maybe early interventions could prevent or reduce any sort of group differences later on in life.

“I see this as the first step in a long series of studies or work, all adding up to that point of being able to design an intervention if we do find differences.”