Purpose: Over an 18-month period in 2020–2021, the North Carolina Early Hearing Detection and Intervention (EHDI) program in collaboration with the North Carolina Leadership Education in Neurodevelopmental and Related Disabilities (LEND) program conducted a statewide examination of newborn hearing screening practices in North Carolina’s 24 Neonatal Intensive Care Units (NICU) and 86 well-baby nurseries to determine how current protocols and procedures conform to those recommended by the Joint Committee on Infant Hearing (JCIH) in its Year 2019 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs. The COVID-19 pandemic emerged during the study period and motivated a second aim, to examine the impact of the pandemic on infant hearing screening.

Results: Our findings revealed that the hospitals in North Carolina are fully committed to their hearing screening programs as demonstrated by a 100% response rate and numerous strengths in both the NICU and well-baby nurseries. Even so, for many hospitals we identified opportunities for program development or improvement based on JCIH 2019 recommendations, especially those concerning oversight of the screening program by a pediatric audiologist, direct referral to an audiologist for NICU babies who fail the in-hospital screening, and audiology referral for well babies who fail the outpatient rescreen. Following the investigation, the NC-EHDI program has worked in partnership with hospitals to provide information, technical assistance, and resources based on our findings and recommendations. The authors would be happy to share the survey instruments and other resources developed for this project with EHDI programs in other states interested in conducting a similar study.