At a time when, in most countries, the profession of school psychology is experiencing a period of growth and expansion, many problems still remain. The origins of these problems are linked to the historical development of the profession which has provided school psychologists with a unique and distinctive role in administering IQ tests and using the results to make decisions about special educational provision for children with learning difficulties. This article reviews recent research that is heavily critical of the relevance of IQ testing and the associated medical model of working, and then considers some of the barriers which prevent school psychologists from changing their practices. It concludes with suggestions as to how the profession can move forward with confidence, knowing that it can make a distinctive contribution to supporting vulnerable children, schools and communities around the world.