How to bind the keyboard autoclicker to a window in the background?

Question

Python

wrote a clicker mini-code, works in the browser and the system as a whole, but does not want to see it in DotA. I would like to bind to the Dota2 window, even if it is in the background.
upd. Initially, I just wanted to click through Clickerman, but when binding to a window, the functionality simply disappears. Without anchoring, it clicks into the window, but when anchored, it does not work either in the background or when the window is active.

import keyboard
import pyautogui as auto
import pyglet
import time
def s():
    while not keyboard.is_pressed('shift'):
        time.sleep(0.1)
        keyboard.send ("Q")
keyboard.add_hotkey('ctrl + alt', s)
input()