The participation of a student with Oppositional Defiant Disorder (ODD) in recess can be both challenging and rewarding for both the student and teacher. Recess may be a small part of the school day but its contributions to a child's social and physical well-being are immense (Kovar et. al., 2012). To increase understanding of ODD, this paper will define the disorder as well as address its prevalence, causes, and characteristics. It will then provide benefits of recess as well as modifications to increase the recess experience for children with ODD.

Definition and Prevalence of Oppositional Defiant Disorder

ODD is a part of a group of behavioral disorders called disruptive behavior disorders. They are given this name because individuals who have this type of disorder tend to disrupt life around them. ODD is defined by the American Academy of Child and Adolescent Psychiatry (AACAP), as "a pattern of disobedient, hostile, and defiant behavior directed toward authority figures" (Frequently Asked Questions: American Academy of Child and Adolescent Psychiatry, 2017, p.1). Most children have days or moments when they are unruly, however children with ODD will have a history of these types of actions and will showcase them often. The most common behaviors exhibited by individuals with ODD are defiance, spitefulness, negativity, hostility and verbal aggression (Oppositional Defiant Disorder: A Guide for Families by the American Academy of Child and Adolescent Psychiatry, 2017).

The Individuals with Disabilities Education Act (IDEA) states that children who are diagnosed with disabilities receive special education if the condition negatively affects the educational performance of the child. One disability category defined in IDEA, which includes a variety of specific disabilities, is emotional disturbance (ED). (Emotional and Behavioral Disorders in the Classroom, 2017). ODD is an ED--note characteristics B and C in IDEA's definition of ED:

"(i) The term means a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child's educational performance:

(A) An inability to learn that cannot be explained by intellectual, sensory, or health factors

(B) An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.

(C) Inappropriate types of behavior or feelings under normal circumstances.

(D) A general pervasive mood of unhappiness or depression.

(E) A tendency to develop physical symptoms or fears associated with personal or school problems.

(ii) The term includes schizophrenia. The term does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance" (CFR [section]300.7 (a) 9) (IDEA, 2007).

The prevalence of ODD is something that is not exact, but it has been suggested that between 1 and 16 percent of children and adolescence have this disorder. If one were to take the average of these figures--8.5 percent, this would be roughly one out of every twelve children. This disorder is usually present once a child hits late preschool or early elementary. In younger children the prevalence tends to be higher in males; however this ratio tends to balance out once school age is reached. It should be noted that there is a higher rate of occurrence within lower socioeconomic groups, however this disorder does affect groups of all types (Oppositional Defiant Disorder: A Guide for Families by the American Academy of Child and Adolescent Psychiatry, 2017). When thinking of why this might be, the environmental factors discussed in the causation may come into play.

Causes of Oppositional Defiant Disorder

There is no definitive cause of ODD, but it is believed that there may be a combination of inherited and environmental factors that lead to the disorder. An individual's natural disposition or temperaments, along with the differences in the way his/her brain and nerves function are believed to be the inherited genetic factors that can lead to ODD. These may come into play with environmental factors such as problems with parenting including lack of supervision, harsh or inconsistent discipline, neglect, or abuse (Mayo Clinic, 2015). The American Academy of Child & Adolescent Psychiatry believes that ODD tends to occur in families with a medical history that consist of Attention Deficit Hyperactivity Disorder, mood disorders, and substance use disorders (Oppositional Defiant Disorder: A Guide for Families by the American Academy of Child and Adolescent Psychiatry, 2017).

Characteristics of Oppositional Defiant Disorder

The importance of diagnosing ODD is very important. ODD varies from person to person and not one person is the same. ODD has many signs and symptoms in children as noted below. The diagnosis is made by psychiatrist. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, ODD can vary in severity in terms of the three categories:

* Mild. Symptoms occur only in one setting, such as only at home, school, work or with peers.

* Moderate. Some symptoms occur in at least two settings.

* Severe. Some symptoms occur in three or more settings (American Psychiatric Association, 2013).

For some children, symptoms may first be seen only at home, but with time extend to other settings, such as at school and with friends.

The DSM-5 criteria for diagnosis of ODD show a pattern of behavior that:

* Includes at least four symptoms from any of these categories --angry and irritable mood; argumentative and defiant behavior; or vindictiveness

* Occurs with at least one individual who is not a sibling

* Causes significant problems at work, school or home

* Occurs on its own, rather than as part of the course of another mental health problem, such as a substance use disorder, depression or bipolar disorder (American Psychiatric Association, 2013)

It is also important to note that the DSM-5 criteria for diagnosis of ODD include the following symptoms that are both emotional and behavioral:

* Angry and irritable mood:

* Often loses temper

* Is often touchy or easily annoyed by others

* Is often angry and resentful

Argumentative and defiant behavior:

* Often argues with adults or people in authority

* Often actively defies or refuses to comply with adults' requests or rules

* Often deliberately annoys people

* Often blames others for his or her mistakes or misbehavior

Vindictiveness:

* Is often spiteful or vindictive

* Has shown spiteful or vindictive behavior at least twice in the past six months (American Psychiatric Association, 2013)

These behaviors must be displayed more often than is typical with the child's peers. For children younger than 5 years, the behavior must occur on most days for a period of at least six months. For individuals 5 years or older, the behavior must occur at least once a week for at least six months (Mayo Clinic, 2015, p.1).

Benefits of the Recess Setting for Children with Oppositional Defiant Disorder

Simply stated, the benefits of the recess setting are high for all children. Included in these benefits are both physical and social benefits. Physical benefits of recess include the following:

* Improvement of out-of-school activity levels--children usually are involved in physical activities on days in which they participate in in-school physical activities (Dale, Corbin, & Dale, 2000).

* Improvement of general fitness and endurance levels for children (Kids Exercise, 2009).

However, for children with ODD, the social benefits of recess are more important than the physical benefits. Imagine a student with ODD being completely included with peers in recess activities in a non-aggressive, calm, and respectful manner (often the opposite of symptoms common with individuals with the disorder). How is this to be accomplished? The following recommendations address this question.

Recess Modifications for Children with Oppositional Defiant Disorder

To achieve the aforementioned goal of addressing some of the characteristics often associated with recess, a few procedures should be put into play. The following recommendations should be considered:

* Clearly define the behaviors you expect. As with all times, students should know what games and activities are appropriate for recess. These activities should be discussed and repeated weekly. Always state the desired behaviors, and thus the rules, in the positive.

* Clearly define the consequences of compliant and noncompliant behavior. There should be no "grey" area for the student as to what can and can't be done in the recess setting.

* Always be firm and consistent. Students with ODD can seem to be looking for an opportunity to challenge directives or justify their position.

* During confrontations at recess, do not allow emotions to rule. With students with ODD, teacher anger demonstrates that they are in control. Stay cool, calm, and collected under the most challenging situation (Woolsey-Terrazas, & Chavez, 2002) (the above are modified teaching strategies for the recess setting by the author of this manuscript).

Other recommendations for the inclusion of children with ODD in recess include the following four items which were listed in School-Wide Strategies for Managing ... Defiance/Non-compliance (2017).

* Allow the student a "Cool-Down Break" if the student becomes agitated (Long, Morse, Newman, 1980). This break can be simply walking with the student for a few moments.

* Ask open-ended questions. Posing "Who", "What", or "Why" questions can allow the student and the teacher to identify the reason for the undesirable behavior (Lancely, 1999)

* Emphasize the positive in teacher requests. The teacher avoiding negative phrasing and instead saying things such as "I will help you with the problem that is occurring in your game" are desired (Braithwaite, 2001).

* Do not embarrass the student (Spirkck, Borgemeir, & Notlet, 2002). This is true even with overdone positive feedback, such as "You are doing a great job in recess today." Know your student and start by giving such feedback one-on-one.

Conclusion

The participation of a student with ODD in recess can often be both challenging and rewarding for both the student and teacher. The rewards can manifest themselves in the ability of the teacher to guarantee the safety of all students in an instructionally sound environment. This paper has hopefully addressed some basic concerns and solutions to improve the recess setting of students with ODD.

Works Cited

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders 5th ed). Washington, DC: Author.

Braithwaite, R. (2001). Managing aggression. New York, NY: Routledge.

Dale, D., Corbin, C., & Dale, K. (2000). Restricting opportunities to be active during school time: Do children compensate by increasing physical activity levels after school? Research Quarterly for Exercise and Sport, 71(3), 240-248.

Emotional and Behavioral Disorders in the Classroom. (2017). Education Corner. Retrieved October 10, 2017 from https://www.educationcorner.com/behavioral-disorders-in-the-classroom.html

Frequently Asked Questions (2017) American Academy of Child and Adolescent Psychiatry Retrieved October 9, 2014 from https://www.aacap.org/aacap/Families_and Youth/Resource Centers/Oppositional_Definat_Disorder_Resource_Center/ FAQ.aspx

Individuals with Disabilities Education Act (IDEA), Pub. L. No. 108-466. (2007).

Kids and exercise: The many benefits of exercise. (2009). Retrieved September, 30, 2017 from http://kidshealth.org/parent/fitness/general/exercise.html

Kovar, S., Combs, C., Campbell, K., Napper-Owen, G., & Worrell, V. (2012). Elementary classroom teachers as movement educators (4th Ed.). McGraw-Hill: Boston, MA.

Lanceley, F. (1999). On-scene guide for crisis negotiators. Boca Raton, FL: CRC Press.

Long, N., Morse, W., Newman, R. (1980). Conflict in the classroom. Belmont, CA: Wadsworth Publishing Company.

Mayo Clinic. (2015) Oppositional Defiant Disorder. Retrieved from http://www.mayoclinic.org/diseases-conditions/oppositionaldefiant-disorder/ basics/casues/con-20024559 on October 10, 2017.

Oppositional Defiant Disorder: A Guide for Families by the American Academy of Child and Adolescent Psychiatry (2017). American Academy of Child and Adolescent Psychiatry Retrieved October 13, 2017 from https://www. aacp.org/App_Themes/AACAP/docs/resource_center_odd_ guide.pdf

School-Wide Strategies for Managing ... DEFIANCE / NONCOMPLIANCE (2017). Retrieved October 15, 2017 from http://www.interventioncentral.org/behavioral-interventions/ challenging-students/school-wide-strategies-managingdefiance-non-compliance.

Spirick, R., Borgmeier, C., Nolet, V. (2002). Prevention and management of behavior problems in secondary schools. In Shinn, M., Walker, H, and Stone, G. Intervention for academic problems II: Preventive and remedial approaches. Bethesda, MD: National Association of School Psychologists.

Woolsey-Terrazas, W. & Chavez, J (2002). Strategies to work with students with oppositional defiant disorder. The Council for Exceptional Children Today, 8(7), 12.

Matthew D. Lucas, Ed.D, C.A.P.E., Associate Professor, Health, Athletic Training, Recreation, and Kinesiology, Longwood College

Amelia G. Erickson, Liberal Arts Major, Concentration in Elementary Education, Longwood University