Concussions, bruises, bite marks: San Antonio special education teachers say they often get hurt at work

Listen to part 2 of this feature below:

From Texas Public Radio:

When Margo Jimenez got a message from her husband’s school telling her to go to the hospital in February, the possibility that he might be hurt enough to die never entered her mind.

Her husband Alfred Jimenez Jr. worked for the Northside Independent School District in San Antonio as an instructional assistant in a self-contained classroom for special education students who need more support than they can get in a general education classroom.

“I just grabbed my purse, and I left,” Margo Jimenez said. “And I finally get there, and, you know, I’m thinking it’s not a big deal. He’s maybe broken a leg or something.”

Even after she arrived at the hospital and the doctor told her Fred needed emergency surgery to try to stop the bleeding in his brain, Margo thought he’d recover.

She was still struggling to believe he might not wake up when he took his last breath ten days later.

School is supposed to be a safe place for both students and staff. Even though that sacred ideal has been shaken by the horror of Uvalde and Sandy Hook and Parkland and Santa Fe, it’s still difficult to comprehend that trying to calm down an upset teenager with an intellectual disability could lead to a push strong enough to kill a 73-year-old man.

But after Fred’s death, his colleagues and his wife said they realized that there were warning signs: the bruises and workplace injuries they’d come to accept as just part of the job.

“One day, he came home with a black eye, his glasses were broken, and he had bites on his arm,” Margo Jimenez told TPR in an interview at her home six months after Fred’s death. “I said, ‘Well, did you report it?’ He said, ‘no.’ I said, ‘Why not?’ He said, ‘Margo, because it happens all the time, every day, every day.’ It’s just a different teacher. It happens all the time.”

A widespread pattern

A 77-page grievance obtained by TPR alleged that the death of Fred Jimenez was part of a widespread pattern of student-caused injuries at Northside ISD, especially in self-contained special education classrooms. In exhibits full of photos and email exchanges between teachers and administrators, the document made the case that Northside’s special education teachers and instructional assistants, usually called IAs, don’t have enough district support to keep them safe and that insufficient staffing and training leads to regular injuries.

The grievance described the experiences of nine teachers, each at a different Northside campus. Together they painted a picture of how staffing shortages can lead to unsafe conditions when there aren’t enough trained adults around when a special education student has a violent outburst.

According to the grievance, one teacher was grabbed by the hair and thrown to the ground, knocking her out. Another had a student who routinely bit their classmates. A third spent months without an instructional assistant after two IAs in a row were injured and asked to be transferred.

Sprinkled throughout the exhibits were photos of different teachers with black eyes, bruises, and bite marks.

TPR requested a copy of the grievance from the district under the Texas Public Information Act, but attorneys for the district requested an exception from the state attorney general’s office, asserting that the grievance is “pending litigation.”

District officials declined TPR’s request for an interview about the grievance, describing it as an ongoing personnel matter.

TPR confirmed the contents of the grievance with several people involved with filing it, including multiple teachers.

Veteran special education teacher Sheree Kreusel is one of seven Northside teachers who signed the grievance. She works in a class for students with intellectual disabilities called an Alternative Learning Environment.

Fred Jimenez worked as an IA in Kreusel’s middle school classroom for five years before he moved to Brandeis High School. He was working at Brandeis when he died.

“Fred was the first time somebody actually died, but teachers are injured all the time, all the time,” Kreusel said. “I’ve had so many injuries. I’ve had three concussions, two broken noses, stabbed in the stomach [with a pen], numerous bites, scars from bites. And that’s just kind of a normal thing, unfortunately.”

Kreusel said some years she had no problems with kids in her class, but other years she was so covered in bruises that people who saw her assumed she was in an abusive relationship.

Despite her repeated injuries, she said she loves her students and doesn’t blame them for hurting her.

“The student may be aggressive, but it doesn’t mean they are targeting you because they hate you,” Kreusel said. “That’s usually not the case. It’s usually something that has happened, and they might be nonverbal. They can’t express it, and they just blow up.”

“I don’t want people to think because of what happened to Fred that all the kids are like that, because they’re not,” she added. “Because the majority of them are fabulous human beings, better than most any of us.”

The problem, Kreusel said, is that there isn’t enough staff to handle student outbursts. She said there’s always been kids that act out. But she said in recent years Northside has had a severe staffing shortage, which sometimes left them without enough staff to protect both themselves and their students.

“What will happen is, [at] the beginning of the year, I’ll think, ‘Oh, this is so great. I’m fully staffed. We have enough help.’ And then they’ll take an IA and put them somewhere, or there’ll be two teachers, because we have 18 kids or 19 kids, and then they need that teacher somewhere else, so they’ll take that teacher and put them in a position that’s open,” Kreusel said.

Experts told TPR there should be at least three adults assigned to a classroom with a student prone to aggressive behavior.

School districts in Texas and across the country have reported difficulty finding enough special education teachers and classroom aides.

In an email included in the grievance, Kreusel was so desperate for help two years ago after central office administrators decided to double the number of students in her class that she emailed the former superintendent.

“In my room I have 3 students who need constant restroom with 2 people assisting. [The other teacher] has 3 students who need restroom also,” Kreusel wrote. “Today alone, I personally have changed 4 poopy diapers, 3 wet ones, and done 4 clothes changes. In my room we have a young lady that has screaming aggressive fits and has to be contained in an area so she doesn’t hurt the other students, herself or staff. I must have someone with her at all times, but she does not have a one on one [IA].”

According to Kreusel, district administrators did come to observe her class after she emailed the superintendent, but their decision to combine the classes did not change.

“They stood in my room for 15 minutes and watched a student having a meltdown trying to hit other students, hitting, biting, etc. seriously hitting me,” Kreusel wrote in an email to the teacher union president. “A week later they held a staffing to tell me what I was doing wrong. They took [the other ALE teacher] anyway and left my students and staff to be injured over and over for the rest of the year.”

Another teacher involved in the grievance described the impact of teacher vacancies on the remaining special education staff. According to her exhibit, she was told to leave her self-contained class at a Northside elementary school for hours at a time in order to work with special education students in general education classrooms who didn’t have a certified special education teacher.

“She often does not get her lunch or conference,” the grievance said. “She asks for support from [a district administrator] and is not comfortable with his suggestion to leave her IA alone and not comfortable being pulled to take data in Collab while her own ALE students are without a teacher in the classroom for extended periods of time. She does the work of three employees and feels unable to keep up.”

“There was always some point where there was something unsafe,” said the teacher, who spoke to TPR on the condition of anonymity. “IAs would have to watch whole units on their own.”

Later that school year, the teacher was asked to help in another classroom during a crisis and hurt her leg.

She said she was sent to a clinic that was in-network for Northside’s workers comp insurance to treat her injury, but because she didn’t have a concussion the doctor told her he was required to send her back to work the same day.

The teacher later found out her leg was injured so badly it required surgery, but she didn’t know that for a month because the workers comp insurance wanted more proof of her injury before it would approve an MRI.

“I was in a wheelchair for 30 days waiting for an MRI,” the teacher said. “I felt like I had been deserted. The district did not care.”

She said the primary reason she feels unsafe at school is that there isn’t enough staff to meet student needs.

“Most of those students have behavior goals, and a lot of them have goals for aggression,” the teacher said. “Depending on what the student’s IEP is, they may need an out-of-class cooldown. Well, then one person goes with them, and it leaves only one person left in the classroom. And then without extra staff there’s no moving anyone around. We have to call someone from somewhere else, and then now they’re short staffed.”

She said another challenge caused by teachers being moved around is that the teachers aren’t familiar with the students’ needs and triggers. She said that probably contributed to her getting hurt when she was pulled into another classroom to help.

A national shortage

When school districts are unable to hire enough special education teachers, aides, and specialists, students with disabilities miss out on therapy and learning opportunities that they are legally entitled to.

In some parts of the country, the special education staffing crisis is so acute that students with disabilities are missing school because districts don’t have the staff they need to support them.

Those shortfalls led parents of students with disabilities to file a record number of complaints with the U.S. Department of Education’s Office of Civil Rights last year.

The Northside grievance makes the case that parents of students with disabilities should be concerned the staffing crisis also makes their children less safe.

“We constantly, constantly say that the employees’ working conditions are the students’ learning conditions. And that is absolutely the case here,” said Northside teacher union president Melina Espiritu-Azocar, who helped the teachers file the grievance.

“We need to do something different, and it’s not for themselves as individuals, but it’s for the students,” she added. “Safety in that classroom for staff is also safety in the classroom for students.”

Sheree Kreusel said most of the time when she’s hurt at work it’s because she’s trying to protect students.

“I have to get in the way of the student that’s being aggressive to protect the other students, because a lot of times, the students don’t understand what’s happening and they just stand there,” Kreusel said. “Or the student is trying to hurt themselves. You know, they’re biting or doing something to themselves, and I have to try to intervene to protect the student that’s being aggressive.”

Kreusel said when a student gets upset and has a violent outburst, she tries to find out what’s wrong by having the student point to pictures in the room.

“We have visuals that we can use with the students because you don’t want to verbalize too much, because a lot of times, if you verbalize to them, or if you get upset and start using a voice that is upset, it will make them more upset,” Kreusel said. “You have to try to stay calm. Also, you try to get them to use whatever strategies they have that you have set up for them — if it be deep breathing, if it’s [going] to their happy place. There’s a lot of different things that we use to try to prevent what’s happening.”

If she has an instructional assistant with her, Kreusel said she sends the assistant out of the room with the other students so they don’t get hurt. She stays behind to watch the student who is upset and try to help them calm down.

“You let them throw computers or throw whatever. But if they’re hurting themselves, or, you know, if it gets worse, if they’re trying to hurt the other person, you do have to restrain them,” Kreusel said. “But it’s also very difficult, because most of my students are bigger than I am.”

A call for change

The nine teachers who provided evidence for the grievance worked with the Northside chapter of the American Federation of Teachers to file the complaint.

Espiritu-Azocar said the grievance represented the collective concerns of special education teachers and aides throughout the district, not just the nine teachers who provided evidence and the seven teachers who signed it.

“After the death of Mr. Fred Jimenez, it became very apparent that the concern of our members was clear. They did not want to go to work and not come home,” Espiritu-Azocar said. “And it was incredibly important for our members that we work with them to ensure that they were safe at work.”

Espiritu-Azocar said the union has been working with members individually for several years to address specific safety concerns in self-contained classrooms as issues came up, but Fred’s death heightened the urgency of their concerns and made union members realize they needed to work together to call for systemic change.

She said many more teachers would have signed the grievance, but they were afraid of retribution.

“We hear it constantly, every single day: ‘I can’t advocate for myself because I’m going to be retaliated against; because I’m going to be blacklisted,’ ” Espiritu-Azocar said. “We must end this idea or this culture of retaliatory behaviors when individuals speak up. There’s nothing wrong with saying ‘this is not working right now, and we need to do something different.’ There’s nothing wrong with saying ‘my rights are being violated, and I need that to be addressed.’ ”

Espiritu-Azocar said special education assistants also wanted to sign the grievance, but Northside AFT advised them not to because they don’t have the protection of a contract.

“It’s harder for them as hourly employees and as at-will employees, to want to come forward and to sign something,” Espiritu-Azocar said. “They were there. They wanted to do it. We felt it was best for them not to.”

A formal grievance filed with Texas school districts has four levels, culminating in a hearing with the school board. State statute requires parents and employees to complete the local grievance process before appealing to the Texas Education Commissioner or the district court.

Espiritu-Azocar said the union is trying to work informally with the district to enact change.

“We don’t want this to turn into a fight.” she said. “All we’re wanting to do is work as a united front with district leadership to resolve these concerns. A human being died. A human being lost his life at work. We cannot shove this under the rug, and we won’t allow it.”

According to the Texas Department of Insurance, five Texas public school employees died of fatal occupational injuries in 2022, the most recent year statistics were available. Those five deaths included the two teachers killed in the Robb Elementary School shooting.

The grievance asked Northside officials to make eight changes to better protect students and staff, including “adequate staffing levels,” safety protocols “tailored to the unique needs of the classroom setting,” and annual training in de-escalation techniques for all staff who work in self-contained special education classrooms, including substitutes.

A close look at policy

In a September interview with TPR, Northside ISD’s Tracy Wernli said the district took a close look at policies, procedures, and safety after the death of Fred Jimenez the previous semester.

“That’s absolutely one of the worst things that could happen. Absolutely devastating,” said Wernli, who oversees special education services for the district. “And so that was something we all took very personally.”

Northside ISD officials declined TPR’s request for an interview about the grievance. However, Wernli agreed to answer more general questions about the district’s special education services. Many of the concerns raised in the grievance have also been expressed during public comments at board meetings, and in an interview with TPR in February.

Wernli said one of the things the district took a close look at after Jimenez’s death was training, and over the summer the district started implementing a new crisis intervention training program called Safety Care.

“It’s a two-day training that teachers will go through, and a large hunk of that training is de-escalation of behaviors, so that the hope is you don’t have to get into a restraint,” Wernli said. “Every week this school year, for two days a week, we’re rolling out that training to train our Applied Learning Environment teachers, our Behavior Mastery Center teachers, and our instructional assistants, and then an administrator on each campus.”

Special education experts and advocates say restraints should only be used as a last resort to prevent students from hurting themselves or others.

Wernli said Northside’s previous training was only one day long and didn’t have as much focus on de-escalation. She said the district had been considering changing crisis intervention training programs “probably for three years.”

“We’re so big, whenever you decide to make a move like that, it’s a very thought-out process,” she said.

Northside is the fourth largest school district in Texas and the largest district in San Antonio, with about 101,000 students.

According to Espiritu-Azocar, the district agreed to provide the de-escalation training after the union filed the grievance last semester.

With the new training underway, Espiritu-Azocar said staffing is the biggest piece that needs to be addressed. The grievance asks for “adequate staffing levels” and for district administrators to consider the level of support students need when deciding how many aides to place in a self-contained classroom.

“Look at the individual needs of students, and let’s stop looking at just a number, because that’s how people get hurt,” Espiritu-Azocar said. “When educators and teachers come forward and say, ‘We need another staff member,’ they’re not saying it for the heck of it.”

Although the difficulty hiring enough special education teachers and aides makes it challenging for districts to fill all of their positions, Espiritu-Azocar said Northside should still make allocations for all of the staff needed in specialized classrooms and make every effort to hire them.

Teachers interviewed by TPR said one major issue with the current assistant allocation system is that a student’s behavior is not part of the criteria.

Sheree Kreusel said it also takes too long for a student to be moved to another environment that better meets their needs.

“If they know somebody’s aggressive, there’s a huge, long, long, long process to get them to what we call a more restrictive environment because you have so much data you have to take,” Kreusel said. “Well, in the meantime, teachers are getting injured. Students are getting injured. A lot of times I would get injured because I’m trying to protect the other students from somebody that is aggressive.”

Northside vacancies

As the central office administrator in charge of special education for the district, Wernli said staffing shortages make it difficult for Northside to find enough special education teachers and assistants.

“That’s a struggle across the state, probably across the country,” she said.

Wernli said about a month after the start of the school year, Northside had 145 teacher vacancies, and 98 of them were in special education. Northside has 126 schools, averaging out to about one to two vacancies per campus.

“Right now a lot of our central office staff [are] out supporting campuses, training long-term subs or serving as a teacher right now in order to help with that,” Wernli said.

“Our campus principals are very creative in trying to schedule and help people out,” Wernli added. “But it does cause a struggle on a campus if you have a couple people out.”

When Northside is unable to hire a certified special education teacher, Wernli said the district looks for a long-term substitute and provides them with additional training in special education.

“We do try to ensure that our subs are trained and that we’re getting subs to be there, but if not, we have to get creative,” Wernli said.

Wernli said Northside also had 103 instructional assistant vacancies in mid-September, although some of them might not be in special education.

More than 6,900 teachers and 1,200 instructional assistants work at Northside. More than 16,100 Northside students received special education services last year.

Staffing solutions and challenges

According to Boston University Professor Elizabeth Bettini, one of the key factors associated with special education teachers staying on the job is consistent and sufficient support from instructional assistants. But research conducted by one of her doctoral students found that special education assistants are even more likely to quit than special education teachers.

“We don’t have nearly as much research on the paraprofessional workforce, but what we do have indicates similar problems, if not worse,” said Bettini, whose research focuses on the special education workforce.

Her doctoral student, Lindsey Kaler, found that 43% of special education assistants quit their job every year.

“That’s compared to like 22% [of] special ed teachers,” Bettini said. “Those are both ridiculously high, but that paraeducator rate is atrocious.”

Bettini said another key piece of research from the CALDER Center found that schools have more special education assistant positions open than any other type of position. “And those vacancies stay open longer,” she added, “meaning that there’s not people filling them.”

The CALDER Center is a research collaborative that analyzes longitudinal education data.

States and districts across the country have long had difficulty finding enough special education teachers. But Bettini said the problem is especially acute in Texas.

“I think Texas has one of the highest rates of special education vacancies in the country and the highest rate of uncertified folks,” Bettini said. “Nearly 40% of newly hired special educators in the state of Texas are being prepared through for-profit programs, which — some of [those programs] are at risk of being decertified by the state because they’re so bad.”

Bettini said there hasn’t been much research on what would help keep more special education assistants on the job, but she believed that better pay and better training would both be a big help. In some parts of the country they’re called teacher’s aides; in others they’re called paraprofessionals. But everywhere they’re considered entry level positions that don’t require a degree, and they’re usually not paid very well.

According to district officials, Northside pays special education assistants $15.38 an hour starting out. According to Fred Jimenez’s workers compensation paperwork, he made $16.91 an hour when he died, and he was in his tenth year working for the district.

Limited funding

Wernli said Northside’s ability to raise salaries is limited because the state hasn’t raised funding for schools since 2019.

“We have to set our salaries and set everything based on the money that we receive,” Wernli said. “Funding is a whole issue that needs to be looked at in the state of Texas for education, and that would have an impact on salaries, absolutely.

Federal law requires public schools to meet the needs of students with disabilities. Wernli said Northside does the best it can to meet those needs, but it doesn’t get enough funding from the state and federal government.

“That’s a big key part,” Wernli said. “We spend a lot more [on special education] than what we’re given (for special education.”

Districts across the country have long reported difficulty finding enough special education teachers, even before the more widespread teacher shortages reported in the wake of the pandemic.

According to Bettini, working conditions play a big role in that shortage.

“Special educators are often being asked to do too much. Their workloads are too big, with insufficient resources to do them well,” Bettini said. “They have to make choices about which students they’re going to provide services to, which services they’re going to provide, which parts of their job they’re going to do well.

“Having to make those choices over and over again, and having to not do the parts of your job that are why you bought into it — over time leads to burnout, dissatisfaction and a desire to leave.”

Wernli said it takes a special kind of person to be a special education teacher or assistant because they often have to take on extra responsibilities like changing diapers.

“That’s kind of the beauty of public school,” Wernli said. “This is somebody’s child. This is their baby. We take them, and we educate them, and we love on them, and care for them. And so there are people that do that and do it with passion and love it, and there are people that it’s just not for them.”

Wernli said she and her colleagues do their best to make special education teachers feel supported.

“We do take that very seriously,” Wernli said. “I don’t think any of us went into this profession for the money. You hear people say that all the time, right? But you want it to be a good working environment, and so that’s all of our responsibilities.”

Nothing missing

However, Wernli doesn’t think there is anything more the district could have done to protect Fred Jimenez.

“There wasn’t something missing, that that was the end result,” Wernli said. “It’s not like, ‘Oh, we should have been doing this.’ There wasn’t something missing.”

She described Jimenez’s death as a “horrible accident.”

Wernli also disagreed with the idea that Northside special education teachers are often hurt at work, especially in self-contained classrooms.

“I don’t know if that’s common. Does it happen? Probably does,” Wernli said. “And we have a process for people to report any kind of injury, and we have a risk management department that would look into that.”

“It might happen more frequently depending on certain students,” she added.

According to the U.S. Department of Education, 4% of teachers reported being physically attacked by a student during the 2020-2021 school year. However, special education teachers in self-contained classrooms also make up a small percentage of teachers overall.

The report’s authors noted that the number is likely lower than usual because many students went to school remotely because of the pandemic that year. Nearly 6% of teachers reported being physically attacked by a student in the 2015-2016 school year.

Northside teachers interviewed by TPR said most of their injuries aren’t targeted attacks. Instead, they said they usually get hurt because they are trying to protect other students or the student from themselves.

Four adults

Bettini said classrooms with students who have unsafe behaviors should have at least three adults in the room at all times — a stark contrast to the experiences described by Northside teachers in the grievance. Bettini said it’s also pretty common for classrooms not to have that staff.

As an example, she said she visited a district in the Boston area who had one teacher and one aide for 10 students, “including several who had very unsafe behaviors.”

“If one of those students had engaged in unsafe behavior, you really need three people to be involved, because you need two people to be part of keeping the students safe, and then you need a third one to collect data,” Bettini said. “So anytime they had an unsafe behavior, they’d have to call the principal, the [special education campus coordinator], and until those folks can get there, there’s not much they can do.”

“It’s really awful. And it meant that every time there was an unsafe behavior, all of the other students missed instruction,” Bettini said. “So there were massive learning opportunities being missed throughout the whole day by all of those other students that they’re legally entitled to.”

In order to keep the other students learning and safe, Bettini said there really should be four adults working with a class during a crisis.

Bettini said in her experience serious unsafe behaviors that result in injuries shouldn’t be happening in the same classroom over and over if a school has implemented a behavior system with fidelity, hired enough staff, and provided them with sufficient training.

“If you have enough personnel who are well trained and running the class well, it should not be common, but it does happen,” Bettini said.

“I taught in those settings for six years, and I was never once attacked by a student,” she added. “I had a student one time punch a hole in a window and injure herself pretty seriously. I had a student who ran towards the train tracks and was saying he’s gonna jump in front of the train.”

Bettini said classroom expectations, school-wide behavioral management programs, and individual behavior plans all play a part in reducing the frequency of injuries. But she said there also needs to be enough staff to implement those plans and respond in a crisis.

“Students who are engaging in these behaviors need consistent, well-trained, well-supported folks,” Bettini said.

Before she became a professor in Boston University’s special education department, Bettini was a middle school special education teacher who taught in a self-contained classroom for students with emotional and behavioral disorders.

She said in the six years she taught in a self-contained classroom significant outbursts that resulted in injuries happened “maybe two to three times a year.”

“You tend to see more extreme behaviors in elementary [grades],” Bettini said. “By middle school, students’ executive functioning [and] their self-regulation skills have developed.”

Bettini taught students with emotional and behavioral disorders, who were often placed in her class because they had “unsafe behaviors.”

Both Fred Jimenez and many of the Northside teachers in the grievance worked with students with intellectual disabilities.

Still unsafe

According to the grievance, Northside is often unable to provide special education students with consistent staffing because of absences, vacancies, and because there aren’t enough aides permanently assigned to self-contained classrooms to manage a crisis.

Espiritu-Azocar and the Northside teachers interviewed by TPR said the staffing shortages remain their biggest concern.

Although she said she’s glad Northside has agreed to provide de-escalation training, Sheree Kreusel said she thinks she and her colleagues in self-contained units will continue to get hurt until the district hires more instructional assistants and pays them well enough that they’re willing to stay.

“First off, they have to hire good people that are willing to do what we have to do, and they have to be trained ahead of time, and they need a higher salary that they can live on,” Kreusel said.

“I’m afraid what happened with Fred, you know, people hear about that, and they don’t want to do this job,” Kreusel said. “I mean, they can get paid more working at Chick-fil-A than being an instructional assistant.”

Kreusel said she hasn’t retired even though she’s 68 because she loves her campus, and she loves making a difference in her students’ lives. But she said she needs the district to know that staff in specialized settings like her are getting hurt all the time.

“It’s not right. You shouldn’t have to go to work and be scared you’re going to be beaten up or bit or kicked or have a concussion or be stabbed or killed. You know, in Fred’s case, killed,” Kreusel said. “I am very proud to be a Northside employee, and I know that something more can be done than what has happened, and that’s why I’m still a teacher.”

Jimenez’s wife, Margo, said she knows her husband wouldn’t blame the student who pushed him, and she doesn’t blame campus administrators either. But she thinks district officials didn’t do enough to keep him safe.

“I feel like they’re responsible. They are, because my husband would still be here if they had more teachers in the room, if they wouldn’t have so many students to that one person,” Margo Jimenez said.

Her grief motivates her to make sure changes are made.

“This is going to have to go somewhere, and I’m not going to let it go,” Margo Jimenez said. “I’ll do whatever it takes ‘til the day I die to make sure that my husband’s death (wasn’t) in vain. Because, oh my god, I would hate for this to happen to anybody else. It’s the worst thing that could happen to you in your whole life.”

If you found the reporting above valuable, please consider making a donation to support it here. Your gift helps pay for everything you find on texasstandard.org and TPR.org. Thanks for donating today.