the brain is composed of neurons which link different parts of the brain together. even with age, there is thought to be plasticity of these neurons to re-wire to other neurons after being damaged. there is no single best way to form these new connections and so a therapist will try to find the best way to reconnect, everyone is a bit different and had different strengths pre-stroke. there are reports, for example, that one stroke patient with aphasia was an ardent card player and a savvy therapist was able to start him talking again by employing card playing as a bridge to other language skills. if someone was an ardent cook, it might be worth trying to resume speech/language therapy in the kitchen. the earlier and more aggressive the therapy, the better chance of some meaningful recovery. and yes, there are reports of stroke patients being able to sing but not speak, so this is yet another avenue. it is not unlike teaching a child skills (which are probably better learned by hands on activities than in remote classrooms) and the more modalities that are involved (vision, auditory, tactile), the better chance that you are stimulating learning and neural connections. i have noticed that families often think that therapy can only be done by physical or speech therapist and strongly feel that the families should take on the responsibility (if time) to engage patient in aggressive home therapy....

you may want to read about Patricia Neal, a famous actress who had strokes at age 39 and after aggressive therapy, recovered enough to continue acting and win awards. it is truly inspiring... ("Less than two years later, in 1965, she suffered a series of strokes. She was only 39. Her struggle to be able to walk and talk again were well documented – especially in a 1991 biopic starring Glenda Jackson – and she returned to the screen to earn another Oscar nomination and three Emmy nominations.&quot


also, there are usually associated physical problems such as paresis (weakness) in an extremity that often will result in contractures (the inability to use an extremity over time because of neural damage peripherally)... a lot of PTs don't get really aggressive but. again, the earlier and more aggressive the treatment, the better chance of some recovery- see splint below:

Dynamic Splints Help Train the Brain

If the hand and arm muscles are no longer functional, it’s especially important to re-learn basic functions first, such as grasping and releasing objects. A stroke rehabilitation device like the SaeboFlex can make this process easier for some patients and possible for those who otherwise would have no function left.
https://www.saebo.com/benefits-rehabilitation-gloves-dynamic-splints-stroke-recovery/

good luck...

forgot to tell you----- if a speech therapist was working with an aphasic patient, they would use pictures, cards with printed words, a audible repetitions with the patient. for example--- show a picture of a piano and ask patient to name the object, then if patient fails, the therapist says "piano, it plays music, etc" and would ideally also print the name "piano" on a card and maybe play a bit of music and pretend or actually play a piano. they then go onto another word. then they repeat the entire sequence again, but you need to be very mindful of how the patient is responding. for example, a pt with both aphasia and apraxia(difficulty speaking) might not be able to say the word but if given an array of pictures, may be able to pick out the card with the picture of the piano or simulate playing the piano---then you need to accept that as a positive response of success to not frustrate the pat. and work in baby-steps (successive approximations), to keep challenging them to achieve more. this part can be an art. when i have worked with patients in the kitchen, i will keep cards with me so i can spontaneously print out the word and you retrain as you would a child but need to closely observe where they are at any given time. for example, you go to the kitchen and say let's bake some cookies. you ask- where are your recipes (print word)- if they cannot find it, lead them to where cookbooks are. then as for recipe of cookies (print card) and ask them to say cookie or try at least. you do this with everything and it is a much superior way than sitting in a therapy room with 4 walls and stupid pictures. then you do more questions...ex- where is the flour, how do we measure it/where are measuring cups, etc., where do we cook them, etc.

different specialist therapists figure out what works best for rehabbing each type of disability - I've learned a lot from your post!

I haven't worked with adults in a while, but some of the information is still in my brain

Singing is a mostly right-brain activity, and some patients with massive strokes will retain their ability to sing, especially "rote" songs like "happy birthday to you" and "abc's" or "twinkle-twinkle little star" especially if the damage is in the left hemisphere.

WRT singing to a person with aphasia, a good SLP, along with a good neurologist, will parse out where the damage is and target therapy accordingly. Some aphasia have a receptive language component and you might need to figure out a different way to communicate.

One advantage in working with an adult versus a child is that an adult presumably was talking before their stroke, so the information is up there - just needs to be accessed, maybe with a new pathway.

Regarding aphasics - I think I understood you to say that some aphasics not only speak gibberish but also hear gibberish when you speak to them, but depending on how much damage from the stroke, it may still be possible to teach them how to communicate...

Here's some information from our national organization:

http://www.asha.org/public/speech/disorders/Aphasia/

Feel free to contact me with any other questions.