|This has a very uncomfortable, true to life, creep factor. Using a child's hand (evidenced by the horsey pajama sleeve) adds to the discomfort. This is the nightmare my mother scared us with all through my childhood.
That said, since this is a Halloween shot, I can cope. Looking back and reflecting, I am raising my initial score.
Assuming that's not real blood, I'd like to know what you used - it sure looks real. I would have chosen a better looking apple if possible, and maybe a red one, to go with the blood.
Still all in all, well done.