Teletherapy for North Carolina Kids and Teens
Live, one-on-one speech therapy, occupational therapy, and mental health care over secure video, with a licensed therapist from our local team in Durham and Chapel Hill.
If therapy at home is hard to picture for your child, you're not alone. We'll help you figure out whether online sessions make sense. If they don't, we'll tell you, and our clinics are there for in-person care.
Our intake coordinator will call you back within 24 hours. You don't need a referral to reach out.
- Since 2016Therapist-led and family-owned
- 24-hour callbackFrom our intake coordinator
- In networkNC Medicaid, BCBS, Aetna, Cigna, UnitedHealthcare, and more
- Best of 2026Best of Durham and Best of Chapel Hill
When Getting to a Clinic Is the Hard Part
Most families look into teletherapy because something keeps getting in the way of regular visits. Maybe one of these sounds familiar.
The drive is too long
A long trip each way is hard to keep up week after week, especially if you live in a rural area. Online sessions take the drive out of it.
Your week is already full
Work, school pickup, and siblings leave little room for a clinic run. A session from home only takes the time of the session.
Leaving the house is a big ask
Limited mobility or a health condition can make getting out the door the toughest part of therapy. Home can be an easier place to start.
Your teen would rather talk from home
Some teens find it easier to open up from their own space than in an office. Online counseling gives them that option.
What We Offer Online
Virtual services are available when they are clinically appropriate and covered by your insurance.
Speech Therapy
Clear speech sounds, language, stuttering, and social communication, using games and activities on a shared screen. Our speech team has a combined 80.5 years of experience.
Occupational Therapy
Fine motor skills, daily routines, and sensory strategies, plus ideas for adapting your home so new skills stick. Not all plans cover OT by teletherapy, so check with yours first.
Mental Health Therapy
Counseling for anxiety, ADHD, and emotional regulation, using approaches such as cognitive behavioral therapy and family therapy.
Looking for physical therapy, ABA, or feeding therapy? These rely more on hands-on work and equipment. Call us and we'll talk through the best way to get your child that care.
How Does Teletherapy Work?
Your child meets with a licensed therapist live, in real time, on secure and HIPAA-compliant video. Here's how you get there.
Reach out
Call us or fill out the appointment form. Our intake coordinator will call you within 24 hours, or sooner, to hear about your child.
We help with the paperwork
We help verify your insurance. If your plan requires a referral, we'll request the orders from your pediatrician.
Your child is evaluated
Evaluations typically last 1 to 2 hours and may include a caregiver meeting. Your therapist reviews the results and recommendations with you, including whether online, in-person, or both makes the most sense.
Sessions begin
Your therapist guides your child through activities and gives feedback as they go, using tools like screen sharing, interactive games, and virtual whiteboards.
Watch our demo: How a Teletherapy Session for Speech Therapy Works (9 minutes)
What you'll need at home
- A computer or tablet with a camera and microphone
- A reliable internet connection
- A quiet, private spot
- A grown-up close by for younger children
What your part looks like
With younger children, you're often part of the session. Your therapist can coach you on what to try, so the work carries over into everyday routines. Older kids and teens may need you only for setup.
Not Sure If Online Is Right for Your Child? Ask Us.
Tell us what's going on and what you've tried. We'll walk you through your options.
Is Teletherapy Right for Your Child?
It can be a great option for many families, but it isn't right for every child or condition. Here's how we think about it.
Teletherapy often works well when
- Travel, schedules, or health make regular clinic visits hard
- Your child can engage with a screen, or you can sit beside a younger child and help
- Goals can be practiced with what you have at home
- You have reliable internet and a quiet place to work
In-person is usually better when
- Your child needs hands-on help or specialized equipment
- Screens stay a struggle, even with a grown-up helping
- Your internet connection is unreliable
- Your plan doesn't cover the service online
When in-person is the better fit, we're here
We'll be upfront with you: many of the children we serve make their greatest progress in person, with access to our sensory equipment and therapeutic tools, so we recommend in-person sessions whenever possible.
Want to come in, but rides are the problem? We list free transportation resources for Wake, Orange, and Durham Counties.
Does Online Therapy Really Work for Kids?
For speech and language therapy, the research is encouraging, though the number of studies is still small. Here's what it says.
- Speech therapy compared with in-person care: A 2024 review of nine randomized trials concluded telehealth "may be a viable alternative" to face-to-face speech therapy. Small trials in preschoolers who stutter and school-age children with speech sound difficulties found no significant difference between groups.
- School-age children: In a 2017 systematic review of seven studies, children improved similarly online and in person on five of six outcome measures. The authors called the evidence "limited but promising."
- Professional guidance: The American Speech-Language-Hearing Association says telepractice can be used alone or combined with in-person care, and should be equal in quality to in-person services.
- Occupational therapy: This research is at an earlier stage. A 2023 scoping review of 31 studies found caregiver outcomes improved and caregivers were highly satisfied with telehealth, but it measured caregivers rather than children's skills.
"...his speech therapist and OT made the Teletherapy easy and very interactive and use subjects he likes to get his attention. They are very patient and work with him to keep him engaged in every session."
Does Insurance Cover Teletherapy?
It depends on your plan and the service. We help verify your coverage before therapy begins. We're in network with:
- NC Medicaid
- BCBS (all except Blue Home)
- United Health Care (All-Saver, Oxford Plan, Bind Benefits)
- UMR
- Aetna (all except Duke Select)
- Cigna
- Amerihealth Caritas
- Healthy Blue
- Carolina Complete Health
- UHC of NC
- Wellcare of NC
- Alliance
- Vayahealth
- Trillium
- Partners Behavior Health
Occupational therapy: Not all plans cover OT by teletherapy. Please confirm with your insurance company before you schedule.
Out of network? We don't bill those plans directly, but we provide receipts with the diagnosis and treatment codes you can submit yourself. See our billing page for details.
Frequently Asked Pediatric Teletherapy Questions
What if my child can't sit still in front of a screen?
That's one of the most common worries we hear, and it doesn't automatically rule out teletherapy. With younger children, your therapist can coach you through play and activities, so your child doesn't have to stay at the screen the whole time. If screens are still a struggle after a fair try, we can talk about in-person sessions.
Will teletherapy just add to my child's screen time?
Sessions are live and interactive, with a real therapist responding to your child. That's a very different experience from watching a show. With younger children, much of the session can happen through play with you, away from the screen.
What ages do you see?
We serve children from infancy through adolescence, ages 0 to 18. Speech, occupational, and physical therapy are available through age 21. Whether online sessions are a good fit depends on your child's age, needs, and goals.
Do I need to be in the room during sessions?
For younger children, yes, plan on being close by and taking part. Older kids and teens may only need help getting set up. Your therapist will tell you what works best for your child.
How long are sessions, and how often?
Speech therapy sessions are typically 30 minutes. Occupational therapy and mental health sessions typically run 45 to 60 minutes. Most children come once or several times a week, based on what your therapist recommends.
How do I get started?
Call us at (919) 378-1340 or fill out our appointment form. Doctors can use our Refer a Patient page. From there, our team will gather a few basic details, help verify your insurance, and schedule an evaluation.
How soon can my child start?
Our goal is to have patients scheduled within 1 to 3 weeks of receiving a referral when a time is open. Times before 3 PM usually open up soonest, and after-school times have the longest waits. Our intake coordinator can tell you what's available now.
Do you require a referral from a doctor?
Not always. Call us to find out. If your insurance requires a referral, we'll handle requesting the orders from your pediatrician.
Does insurance cover online therapy for kids?
It depends on your plan and the service. We're in network with NC Medicaid, BCBS, United Health Care, UMR, Aetna, Cigna, and several managed care organizations, with some plan exceptions. Not all plans cover occupational therapy by teletherapy, so please check with your insurance company.
Can we switch between online and in-person therapy?
Yes, talk with your therapist if your child's needs change. We have clinics in South Durham and Chapel Hill, with a Northwest Durham clinic opening in January 2027. Scheduling and insurance coverage can affect the options available.
Do we have to live near Durham or Chapel Hill?
No. Teletherapy is for families in North Carolina, and your child should be in the state during sessions. Our service area includes Durham, Chapel Hill, Hillsborough, Raleigh, Cary, Apex, and Morrisville. If you live somewhere else in North Carolina, give us a call.
Are online sessions private?
Yes. Sessions take place over secure, HIPAA-compliant video. A quiet, private spot at home helps keep your child's session confidential.
A Local Team, Online or in Person
Therapy Smarts is therapist-led and family-owned, and has been helping children since 2016. We have clinics in South Durham and Chapel Hill, with a Northwest Durham clinic opening in January 2027.
Have Questions? We Are Here to Help
A local, family-owned team, online or in person. Reach out and we'll help you find the right next step for your child.
Last updated November 2026