Reduced Bone Cortical Thickness in Boys with Autism or Autism Spectrum Disorder

  • Mary L. Hediger
  • Lucinda J. England
  • Cynthia A. Molloy
  • Kai F. Yu
  • Patricia Manning-Courtney
  • James L. Mills
Original Paper


Bone development, casein-free diet use, supplements, and medications were assessed for 75 boys with autism or autism spectrum disorder, ages 4–8 years. Second metacarpal bone cortical thickness (BCT), measured on hand-wrist radiographs, and % deviations in BCT from reference medians were derived. BCT increased with age, but % deviations evidenced a progressive fall-off (= .02): +3.1 ± 4.7%, −6.5 ± 4.0%, −16.6 ± 3.4%, −19.4 ± 3.7%, −24.1 ± 4.4%, at ages 4–8, respectively, adjusting for height. The 12% of the boys on casein-free diets had an overall % deviation of −18.9 ± 3.7%, nearly twice that of boys on minimally restricted or unrestricted diets (−10.5 ± 1.3%, < .04), although even for boys on minimally restricted or unrestricted diets the % deviation was highly significant (< .001). Our data suggest that the bone development of autistic boys should be monitored as part of routine care, especially if they are on casein-free diets.


Autism Autism spectrum disorder Boys Bone growth Calcium intake Dietary intake 



This study was supported by intramural funding (Z01 HD008742) from the National Institute of Child Health and Human Development and by a General Clinical Research Center grant (M01 RR08084) to the Cincinnati Children’s Hospital Medical Center. We acknowledge the substantial contributions of Daniel A. Warren, who measured the radiographs as part of his student internship at the NICHD, and Mark Brasington, who was responsible for all aspects of data collection at the Cincinnati Children’s Hospital Medical Center.


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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Mary L. Hediger
    • 1
  • Lucinda J. England
    • 2
  • Cynthia A. Molloy
    • 3
  • Kai F. Yu
    • 1
  • Patricia Manning-Courtney
    • 4
  • James L. Mills
    • 1
  1. 1.Division of Epidemiology, Statistics and Prevention ResearchNational Institute of Child Health and Human Development, National Institutes of Health (DESPR, NICHD, NIH), Department of Health and Human ServicesBethesdaUSA
  2. 2.Division of Reproductive HealthNational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Department of Health and Human ServicesAtlantaUSA
  3. 3.Center for Epidemiology and BiostatisticsCincinnati Children’s Hospital Medical Center, University of Cincinnati College of MedicineCincinnatiUSA
  4. 4.The Kelly O’Leary Center for Autism Spectrum Disorders, Division of Developmental DisabilitiesCincinnati Children’s Hospital Medical CenterCincinnatiUSA

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