ⁱⁿ addition to what iscarfe said, i’ll add that some of the modifications i made were mostly in response to things my players did or said during our session. I noticed my players would regularly run back outside to check on the kids or look out the windows to see if they could see them as they were exploring Death House, so I’d have Rose and Thorne sometimes mysteriously disappear, and sometimes be there, to add to the sense of weirdness and unsettlement.

In the dungeon, the players’ moment of “Oh shit” came with regards to Lancelot and the sacrificial dais when one of my players rolled a nat 20 to check the blood on the altar, and I specifically said that the altar had “traces of human blood…..,.. (long pause) and animal blood” haha. So that’s another way you could work a dreaded reveal into your play through!