Integrating multiple intervention strategies with Cognitive Behavioral Therapy (CBT) tailored for children with autism could improve therapeutic outcomes. However, there has been no direct empirical investigation on how these intervention strategies affect the engagement of children with autism, which further relates to their sensory profiles. This gap leads to a new study exploring the integration of a visually stimulating sensory device, such as Bubble Tube (BT), into classical CBT. BTs are commercially viable and frequently used in sensory rooms and are recognised for enhancing visual perception, supporting color recognition, and improving attention. Despite the widespread use of BTs in clinical interventions, differentiating the effectiveness of passive and active modes of operation has not been explored. Hence, an enhanced version of BT, a Dual Mode Interactive Bubble Tube (DMIBT), is proposed and experimented for its use in CBT. Like BT, the DMIBT can be operated in both active mode (child-controlled) and passive mode (therapist-controlled) to provide versatile visual stimulations by changes in color intensity, bubble speed, and color transitions. To better understand how children with autism engage with the bubble tube in both passive and active modes, a pilot study was conducted with twenty children (n = 20) diagnosed with Autism Spectrum Disorder for five weeks. From the findings it is evident that children’s engagement was significantly (p < 0.001) higher in the active mode compared to the passive mode, and the engagement scores were positively correlated with their sensory-seeking sensory profile scores in both passive(r = 0.871, p < 0.001) and active (r = 0.844, p < 0.001) modes. The results suggest that DMIBT, when operated in active mode, provides greater opportunities for engagement in children with autism and those who have strong sensory-seeking profiles. Furthermore, the real-time customisation of sensory outputs through DMIBT allows children to better enhance their sensory experiences, making it a promising strategy for integration into modern CBT methods. This can ensure active engagement to support sensory regulation, relaxation, or behavioral activation in children with autism.