Introduction: The Reynell-Zynkin developmental scales (R-RZS, Vervloed, 2000) is actually the only play-based, semi-standardized tool to assess the development of children with visual impairment, which is strongly impacted by vision deprivation. The aim of this study is to investigate how the presence of associated disabilities affects the RZ developmental scales in children with VI. Participants and Methods: A retrospective study was designed: 50 children with VI (age 12–42 months; mean age [MA] = 25.8, SD = 8.6; males = 28 [56%]) and visual acuity below 20/60, underwent a consultancy, including the administration of the RZ, from 2015 to 2022, at the Robert Hollman Foundation (RHF), a nonprofit organization that offers support to the development of children with VI since 1979. 17 children with low vision (MA = 23.4, SD = 8.6) and 33 children with low vision and associated disabilities (MA = 27, SD = 8.4), were assessed. The scales were administered to each child only once by the same educator, with a long-lasting professional experience. A Wilcoxon test was performed. Results: Children with VI and associated disabilities showed significantly lower scores in all the RZS considered (p < 0.01); children with VI and psycho-relational disability scored less than those with motor disabilities, even if not significantly. Children with retro-chiasmatic damage scored significantly less than children with pre-chiasmatic pathologies. Conclusions and Relevance for Practice: These findings are relevant for professionals in paying careful attention to the relational aspects in children with VI and associated disabilities and in setting personalized rehabilitation programs according to the diagnosis of VI and the type of associated disability.