There has long been concern in terms of the validity of assessing vision in children with profound and multiple handicaps who are developmentally young. The problem is that, in assessing any specific capacity, most assessment tests rely on the integrity of other aspects of development. Also, conventional tests may not produce educationally relevant data or contain material which is intrinsically interesting to children with profound learning difficulties. This paper reviews the issues relating to the assessment of vision in such children, and demonstrates a standard technique for grading near vision using food items of varying size.