LAYTON, Utah — Couples hoping to adopt should understand exactly what theyre taking on when they "check the boxes" on the adoption form, particularly when it comes to agreeing to take children with irreversible or expensive medical problems, says an expert.Dr. David L. Donaldson, a University of Utah physician speaking to Mormon couples at the Families Supporting Adoption Conference sponsored by LDS Family Services at the Davis Conference Center recently, said its critical that parents consider the emotional, financial and physical demands that come with various conditions.He said often children coming out of foreign orphanages have challenges created by mothers who did not get adequate prenatal care.Genetics plays a part, as does environment, Donaldson said, but toxins like alcohol and drugs affect every cell in the body, particularly the brain.Donaldson said mental problems such as anxiety disorders, depression, schizophrenia, bi-polar disorders, obsessive compulsive disorders, learning disorders and personality disorders may not be evident until a child grows into adolescence.Other problems and complications with cystic fibrosis, epilepsy, visual and hearing impairments, may become chronic conditions that require significant investment.Donaldson said in his work he tends to see children with the worst issues, such as child diabetes and fetal-alcohol syndrome, instead of the successes.I see these kids with diabetes and it really messes up their ability to cope, he said. But I would worry most about extreme behavioral issues. Quite often, some of these children may be long-term adult babies. You have to be willing to say, Ill do almost anything (for this child).Babies whose mothers smoked tend to be smaller at birth, he said, perhaps because they get less oxygen during the pregnancy. Those whose mothers drank or used illegal drugs usually have difficulty sleeping, eating and can have speech and small-motor-skill trouble.He said parents with children with serious medical conditions need to be prepared to teach others and become advocates for their children.Its not something for wimps, he said. Diagnosis ups the ante for parenting. You have to become an empowering parent coach, more so than with a healthy child.Donaldson suggested parents considering adoption have their doctors look over the birth mothers medical records and get information about family history.In conclusion he said: Theres no way to predict the future. In the end you do the same as the parents of any child, hope and pray, identify the needs and get help. Seek a wise, experienced physician. Get a talking doctor.