A Brain-Computer Interface-Based Attention Training Program Compared With Methylphenidate and Citicoline

The goal of this observational study is to learn whether a brain-computer interface (BCI)-based attention training program, used alone or together with medication, can improve attention, executive functioning, and emotional regulation in school-age children with attention difficulties. The study focuses on school-age children who were referred for problems with attention, concentration, or related cognitive and emotional difficulties. The main questions it aims to answer are: Does BCI-based attention training improve children's attention and response control when used on its own? Do children show greater improvements when BCI-based attention training is combined with medication such as methylphenidate or citicoline? Are there differences in attention, executive functioning, or emotional symptoms between children receiving combined approaches versus single treatments? Researchers compared four naturally occurring treatment approaches to see whether combining attention training with medication leads to better outcomes than using one method alone. Participants will: Take part in a computerized, game-based BCI attention training program that uses brain signals to guide training tasks Receive medication (methylphenidate or citicoline) if this was part of their usual clinical care Complete computerized attention tests that measure focus, reaction time, and impulse control Have parents complete questionnaires about attention, behavior, emotions, and everyday executive functioning before and after the intervention This study was conducted in a real-world clinical setting and reflects routine treatment choices made by families and clinicians, rather than random assignment. The findings aim to help families and health care providers better understand how different treatment combinations may support attention and self-regulation in children.