I try to let my quilts speak to me. Some are very outspoken and almost 'demand' custom quilting, or alternating designs in open spaces, etc. Some just don't say anything and are done with an all over pattern--and they are happy with that.
When my new neighbor and new quilter was attempting her first quilt she asked me this question. I told her to lay out her quilt top, leave it for a day but look at it each time she passed and the quilt would speak to her. She called me the next day all excited. "It spoke to me" she said. With equal enthusiasm I asked what it had said. Her reply: "It said HELP!" We still laugh about that all these years later. She has turned into a totally amazing quilter with no problems listening to her quilts.