The snow is an addition of a soft SSS mask for the area offstream and a low octave perlin noise, raising both first (so you get small soft hillocks on terrain), then compute normal and (masked by same blobs+ offstream mask) lateral displacement for the bulging snow. The areas left untouched by that mask are filled with fake stones. The stream has its own SSS, which is warped differently from the snow area.
The trees are Speedtree, but I imported them in ZBrush and dynameshed them into blobs, exported as another object. Imported both with same seed and population variables, and added snow shader.