[3][4][5] A U.S. state regulation from the Colorado Department of Human Services defines Deaf (uppercase) as "A group of people, with varying hearing acuity, whose primary mode of communication is a visual language (predominantly American Sign Language (ASL) in the United States) and have a shared heritage and culture," and has a separate definition for deaf (lowercase).Lower case d-deaf is where a person has hearing loss: typically, those that consider themselves deaf, first and foremost prior to any other identity.It generally refers to people who depend primarily on a spoken language for communication or who have mild or moderate hearing loss.[11] Formerly these terms were neutral, or at least accepted, as can be seen by nicknames such as baseball player Dummy Hoy, or the former names of educational institutions, since renamed, such as Pennsylvania School for the Deaf (formerly Pennsylvania Institute for the Deaf and Dumb), Gallaudet University (formerly National Deaf-Mute College).Martha's Vineyard Sign Language bloomed from necessity due to a high number of hereditary deaf Americans in the area.[14]A desire to express themselves to the world through visually accessible medium may be a reason for such a strong Deaf artist community.Betty Miller's piece Ameslan Prohibited (1972) depicts two shackled hands and chopped fingertips; this powerful image encouraged more Deaf people to reveal their childhood experiences of audism and oralism through art.Others argue that this technology also threatens the continued existence of Deaf culture, but Kathryn Woodcock argues that it is a greater threat to Deaf culture "to reject prospective members just because they used to hear, because their parents chose an implant for them, because they find environmental sound useful, etc.The method is intended to make it easier for deaf children to integrate into hearing communities, but the benefits of learning in such an environment are disputed.