## 4 Discussion  
### Principal Findings  
This study analyzed the impact of mobile-based digital therapeutic interventions on attention and ADHD symptoms in children with ADHD, amidst active research in digital therapeutic interventions. Using NeuroWorld DTx, a game-based program designed to enhance attention, the study examined its potential as an adjunct tool targeting inattention and impulsivity in ADHD children. Evaluation using K-ARS, K-CBCL, and FAIR assessments compared results at baseline and 4 weeks later. A significant reduction in the total K-ARS score of the experimental group, K-ARS attention deficit, and K-ARS hyperactivity were identified. Specifically, reductions were observed in K-ARS attention deficit and K-ARS hyperactivity; K-CBCL internalization, K-CBCL externalization, and the total score of K-CBCL problem behavior were significantly reduced. The FAIR attention index showed improved selection ability and persistence after four weeks in the experimental group. These results verified that NeuroWorld DTx can be used as a treatment tool to support the existing standard pharmacological therapy and as an alternative non-pharmacological adjuvant therapy. According to previous studies involving children with ADHD, digital therapies have reported evidence of improvement in ADHD-related impairments [36, 37]. Specifically, according to the results of AKL-T01 conducted under conditions similar to this  
Figure 6: Frankfurter Aufmerksamkeits InventaR: Q-percentile. Q-standard score.  
Figure 7: Frankfurter Aufmerksamkeits InventaR: C-percentile. C-standard score.  
study, when home-based treatment using digital therapeutic interventions was performed over four weeks, five days a week in pediatric ADHD patients, improvement in the TOVA (Test of Variables of Attention) and API (Attention Performance Index) scores was observed across 20 research institutions in the United States [38]. The API score, as indicated in previous research, represents objective attention scores in children with ADHD. Such improvements in API scores can support the application of digital therapeutic interventions as an alternative to conventional pharmacological treatments, potentially minimizing side effects and reducing the likelihood of misuse [39]. Therefore, the proposed usage of digital therapeutic treatments in this study, involving digital therapeutic interventions performed five days a week over four weeks, demonstrated improvements in inattention and impulsivity scores, increased indices of attentional focus, and reduced total behavior problem scores compared to the control group receiving only pharmacological treatments. These results suggest a comprehensive improvement in ADHD symptoms through new non-pharmacological therapeutic approaches. Mobile-based digital therapies such as NeuroWorld DTx, which utilize games within mobile devices, enhance children's engagement and accessibility, offering a reasonable treatment option with advantages of flexibility in time and space for children with ADHD [40]. Moreover, these therapies provide parents of ADHD children with a therapeutic option that complements pharmacological treatments, considering issues such as the overuse and side effects of pharmacological therapies.