An Integrated Approach to the Exposome

Environmental Health Perspectives • volume 120 | number 3 | March 2012 A 103 that include validated threshold values that can be used to identify children at risk for delayed develop ment or clinically significant behavioral problems (Bayley 1993; Gioia et al. 2003; Wechsler 2002). The comparison of the case child to these values is valid because the distribution of scores for children in our study are comparable to those in nationally representative population-based samples used to validate these instruments. This is how these tools are used clinically to identify children who may have neurobehavioral abnormalities. Finally, Haighton et al. state that other etiologies could be responsible for the abnormal exam at 1 month of age. We stated this exact same point very clearly in our case report (Sathyanarayana et al. 2011). Although these other etiologies may be important in infant and child neurodevelopment, they would be confounders only if they are associated with both BPA exposure and neuro development (Hernan et al. 2002). The authors declare they have no actual or potential competing financial interests.