I love the Wacom Bamboo tablet that I can drawn on the photos of quilts to explore design choices. I learned about this from Carla Barrett, when I took her on-line "Quilt Whisperer" class a while ago.
Above is the next quilt I have to quilt, & below I redrew the designs on a black screen so that they could be seen more easily. I like doing this, because I can draw the designs & tell the client what the charge for each design would be, & she can decide which one she prefers. It makes for a little less anxiety on reveal day, & the client gets some input on the design choice. It's a win-win!