State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that examined 12 areas within state EHDI programs. Concerning periodic early childhood hearing screening, 47 coordinators listed 241 items and themes were identified within each SWOT category. A threats, opportunities, weaknesses, and strengths, or TOWS, analysis yielded 12 recommendations that focused on similar themes. Out of these 12 recommendations, 3 distinct strategies emerged: 1) increase education of parents and professionals about risk factors for later onset hearing loss and hearing monitoring; 2) integrate data systems accessible by professionals that are capable of processing risk factors and multiple hearing screenings; and 3) collaborate with early childhood programs to coordinate follow-up, improve data submission, and conduct periodic hearing screenings. Addressed appropriately, these recommendations can improve periodic early childhood screening within state EHDI programs. (Contains 6 tables.)