I take my que from the quilt top. If it is obviously a child's quilt, I try to put something not so serious as a quilting design. For example, I had a quilt to do that was mostly made with Flintstone fabrics, so I put dinosaurs on it. But if the top is has a contemporary, geometric feel to it, I might use quilting that is really curvy to soften it a little. If it is an applique design, I respect the applique try to enhance that type of design. If the top has a lot of rusts, gold and browns in it, I might use a leaf pattern. I truly do try to "listen" to the quilt top.