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Amid escalating censorship efforts in U.S. schools, South Carolina’s Regulation 43-170 introduces state control over collection development. This qualitative study, based on interviews with 16 school librarians, explores how the regulation affects their daily practices and professional identity. Findings reveal 1) a shift from dynamic, holistic collection development to a rigid, scripted process, 2) increasingly time-consuming and less professionally fulfilling duties, and 3) a loss of trust and respect, replaced by feelings of surveillance and job insecurity. Although intended to ensure transparency, the regulation has led to self-censorship and undermines intellectual freedom. This research offers timely insight into the consequences of state intervention in school library practices and highlights the need for advocacy and professional development within this evolving policy landscape.