I would strongly recommend against a rigorous pruning...this tree doesn't have much left to work with.
The picture with your leaf samples do look like an assortment of fungal pathogens at work. But I would not be surprised at that. Not only are Malus sp host to numerous pathogens but, and correct me here if I am wrong, you have had a wet, warm spring. Ideal for those pathogens to become active.
I would take the fact that the homeowner says this has never happened before with a grain of salt. It is probably more noticeable this year. What you need is weather conditions that are no longer suitable for the pathogen to progress.
The other thing to consider is you are seeing the damage of the fungal pathogen progress now...not necessarily that the pathogen is still active, only the ramifications of it.
If you do not want to take leaf samples to your local extension office for specific diagnosis, then you could at least give them a call to see what is most active in your area. This would assure you on whether the pathogen at work is indeed temporary of not much concern or one that may truly warrant treatment.
Most fungal pathogens on leaves are not considered a problem. With that said, this tree doesn't have many to work with. However, leaves are the most readily "replaceable organ" on a tree. So unless there is a particular virulent pathogen at work (and I don't suspect that), I would be highly reticent to wound the tree further, either by injections or pruning, in treatment.
As always improving the tree's cultural situation may be the best long term help. I am constantly having to remind myself that your Eastern trees are structurally much different than our western trees. But this crabapple is very sparse, which leads me to think it is struggling with competition for light and nutrients. Is there anyway you can mitigate that? You don't show the base of the tree, is it healthy? What is the watering schedule? Go through a checklist with your client to see how this tree is cared for and see if you can suggest improvements for its long term care.
Sylvia